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General NPI Number Information
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NPI Number | 1790085983
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Entity Type | Organization
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Legal Business Name | GREENWICH MEDICAL SERVICES PC
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 66 GLENBROOK RD STE 400
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City | STAMFORD
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State | CT
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Zip | 06902-8402
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Country | US
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Telephone | 203-961-8241
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Fax |
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Provider Business Mailing Address
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Address Line | 66 GLENBROOK RD STE 400
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City | STAMFORD
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State | CT
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Zip | 06902-8402
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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 | PRESIDENT
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Name | ANNA SHENDER
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Credential | MD
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Telephone | 203-961-8241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 000498
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License Number State | CT
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