MEDICARE: MR. GREGORY WARWICK TAYLOR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	046010	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144221607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREGORY WARWICK TAYLOR MD

Provider Business Mailing Address
First Line	:	34 JEROME AVE STE 204
Second Line	:
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-2463
Country	:	US
Telephone Number	:	860-966-9680
Fax Number	:	860-206-6075

Provider Business Practice Location Address
First Line	:	34 JEROME AVE STE 204
Second Line	:
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-2463
Country	:	US
Telephone Number	:	860-966-9680
Fax Number	:	860-206-6075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	11/15/2018

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