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NPI Code Detail

MEDICARE: FAMILY MEDICINE ASSOCIATES OF STAMFORD, P.C.

MEDICARE: FAMILY MEDICINE ASSOCIATES OF STAMFORD, 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
1207Q00000XFamily Medicine PhysicianCT

Other Identifiers

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

General Provider Information

NPI Number : 1780791822
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY MEDICINE ASSOCIATES OF STAMFORD, P.C.
Provider Business Mailing Address
First Line : 1450 WASHINGTON BLVD
Second Line : SUITE 103
City : STAMFORD
State : CT
Zip : 06902-2451
Country : US
Telephone Number : 203-348-2937
Fax Number : 203-348-1968
Provider Business Practice Location Address
First Line : 1450 WASHINGTON BLVD
Second Line : SUITE 103
City : STAMFORD
State : CT
Zip : 06902-2451
Country : US
Telephone Number : 203-348-2937
Fax Number : 203-348-1968
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOHN MICHAEL GREELEY
Credential : M.D.
Telephone Number : 203-348-2937
Provider Enumeration Date : 08/24/2006
Last Update Date : 07/21/2022

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