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NPI Code Detail

MEDICARE: SHORELINE MEDICAL, LLP

MEDICARE: SHORELINE MEDICAL, LLP
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
1207RH0002XHospice and Palliative Medicine (Internal Medicine) PhysicianCT

General Provider Information

NPI Number : 1326254681
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHORELINE MEDICAL, LLP
Provider Business Mailing Address
First Line : 1450 WASHINGTON BLVD
Second Line :
City : STAMFORD
State : CT
Zip : 06902-2451
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1450 WASHINGTON BLVD
Second Line :
City : STAMFORD
State : CT
Zip : 06902-2451
Country : US
Telephone Number : 203-327-9321
Fax Number :
Authorized Official
Title or Position : PRINCIPAL
Name : BRYAN DORF
Credential : DO
Telephone Number : 203-327-9321
Provider Enumeration Date : 05/15/2007
Last Update Date : 08/22/2020

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Directions to “SHORELINE MEDICAL, LLP ” Practice Location

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