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General NPI Number Information
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NPI Number | 1609932151
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Entity Type | Organization
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Legal Business Name | TOWN OF FAIRFIELD
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 100 MONA TERRACE
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City | FAIRFIELD
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State | CT
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Zip | 06824-6684
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Country | US
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Telephone | 203-256-3150
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Fax | 203-256-3172
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Provider Business Mailing Address
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Address Line | 725 OLD POST RD
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City | FAIRFIELD
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State | CT
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Zip | 06824-6684
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Country | US
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Telephone | 203-256-3020
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Fax | 203-254-8850
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. SANDS CLEARY
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Credential |
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Telephone | 203-256-3020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Legacy Identifiers
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Identifier #1
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Identifier Code | 68VNA0052CT01
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Identifier Type | OTHER
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Identifier State | CT
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Identifier Issuer | ANTHEM
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 68VNA0052CT01
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Identifier Type | OTHER
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Identifier State | CT
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Identifier Issuer | ANTHEM
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