Organization Name: | PREFERRED MDCARE, LLC |
NPI Number: | 1003004847 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VIJAY V DESAI (OWNER) |
Mailing Address: | 180 Turn Of River Rd Suite 8c Stamford |
State: | CT US |
Postal Code: | 069051396 |
Phone Number: | 2038207224 |
Fax Number: | 2033559808 |
NPI Enumeration Date: | 10/05/2007 |
NPI Last Update Date: | 10/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |