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General NPI Number Information
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NPI Number | 1427965516
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Entity Type | Organization
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Legal Business Name | NEW YORK CCS MEDICAL SERVICES
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 60 HOUSATONIC AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06604-4026
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Country | US
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Telephone | 615-258-8631
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Fax |
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Provider Business Mailing Address
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Address Line | 6550 CAROTHERS PKWY STE 500
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City | FRANKLIN
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State | TN
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Zip | 37067-6692
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | RICHARD LOUIS MAENZA
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Credential | MD
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Telephone | 412-398-1669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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