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General NPI Number Information
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NPI Number | 1881781029
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Entity Type | Organization
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Legal Business Name | GREENWICH MEDICAL GROUP
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 75 HOLLY HILL LN
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City | GREENWICH
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State | CT
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Zip | 06830-6098
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Country | US
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Telephone | 203-869-6960
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Fax | 203-869-5103
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Provider Business Mailing Address
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Address Line | 75 HOLLY HILL LN
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City | GREENWICH
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State | CT
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Zip | 06830-6098
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Country | US
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Telephone | 203-869-6960
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Fax | 203-869-5103
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. GAIL M FENNELL
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Credential | M.D.
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Telephone | 203-869-6960
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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 | AS8735308
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BL9582493
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | AA2470348
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BF4323503
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | BN3275369
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License Number State | CT
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Taxonomy #6
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | AM6000715
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License Number State | CT
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BV5838959
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License Number State | CT
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