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General NPI Number Information
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NPI Number | 1588995708
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Entity Type | Organization
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Legal Business Name | DOMUS REALTORS & ASSOCIATES LLC
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Dates
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Enumeration Date | 01/28/2010
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 212 BLUE HILLS RD
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City | NORTH HAVEN
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State | CT
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Zip | 06473-1053
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Country | US
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Telephone | 203-287-7550
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Fax | 203-907-1000
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Provider Business Mailing Address
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Address Line | 212 BLUE HILLS RD
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City | NORTH HAVEN
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State | CT
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Zip | 06473-1053
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Country | US
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Telephone | 203-287-7550
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Fax | 203-907-1000
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | DEBORAH MARION BATTISTA
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Credential | DIRECTOR/OWNER
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Telephone | 203-287-7550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | HCA0000418
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License Number State | CT
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