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General NPI Number Information
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NPI Number | 1467471300
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Entity Type | Organization
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Legal Business Name | GREENWICH OTOLARYNGOLOGY, PC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 09/17/2007
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Provider Practice Location Address
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Address Line | 4 DEARFIELD DR STE 104
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City | GREENWICH
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State | CT
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Zip | 06831-5351
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Country | US
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Telephone | 203-629-5500
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Fax | 203-629-8244
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Provider Business Mailing Address
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Address Line | 4 DEARFIELD DR STE 104
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City | GREENWICH
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State | CT
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Zip | 06831-5351
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Country | US
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Telephone | 203-629-5500
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Fax | 203-629-8244
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Authorized Official
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Title or Position | PHYSICIAN
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Name | STEVEN M FELDMAN
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Credential | M.D.
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Telephone | 203-629-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 035952
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License Number State | CT
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