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NPI Code Detail

MEDICARE: STAMFORD NEPHROLOGY, P.C.

MEDICARE: STAMFORD NEPHROLOGY, P.C.
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
1207RN0300XNephrology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609800606
Entity Type Code : Organization
Provider Name (Legal Business Name) : STAMFORD NEPHROLOGY, P.C.
Provider Business Mailing Address
First Line : 30 COMMERCE RD
Second Line :
City : STAMFORD
State : CT
Zip : 06902-4550
Country : US
Telephone Number : 203-324-7666
Fax Number :
Provider Business Practice Location Address
First Line : 30 COMMERCE RD
Second Line :
City : STAMFORD
State : CT
Zip : 06902-4550
Country : US
Telephone Number : 203-324-7666
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : TAMIKO FLEMING
Credential :
Telephone Number : 203-324-7666
Provider Enumeration Date : 07/10/2006
Last Update Date : 02/01/2012

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