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General NPI Number Information
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NPI Number | 1992969364
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Entity Type | Organization
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Legal Business Name | STONY CREEK URGENT CARE CENTER, LLC
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 6 BUSINESS PARK DR SUITE 302
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City | BRANFORD
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State | CT
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Zip | 06405-2988
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Country | US
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Telephone | 203-483-4580
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Fax | 203-483-4581
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Provider Business Mailing Address
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Address Line | 6 BUSINESS PARK DR SUITE 302
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City | BRANFORD
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State | CT
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Zip | 06405-2988
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Country | US
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Telephone | 203-483-4580
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Fax | 203-483-4581
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. DAVID J YOUNG
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Credential | MD
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Telephone | 203-483-4580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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