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General NPI Number Information
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NPI Number | 1831464643
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN FAMILY PRACTICE
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 246 FEDERAL RD STE D12
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City | BROOKFIELD
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State | CT
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Zip | 06804-2648
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Country | US
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Telephone | 203-775-3290
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Fax | 203-775-6970
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Provider Business Mailing Address
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Address Line | 246 FEDERAL RD STE D12
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City | BROOKFIELD
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State | CT
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Zip | 06804-2648
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Country | US
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Telephone | 203-775-3290
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Fax | 203-775-6970
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. CHRISITNE MARIE DALTON
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Credential |
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Telephone | 203-775-3290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 031878
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License Number State | CT
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