Organization Name: | STAMFORD PRIMARY CARE, P.C. |
NPI Number: | 1881895324 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES BIVONA (OWNER) |
Mailing Address: | 1275 Summer Street #107 Stamford |
State: | CT US |
Postal Code: | 06906 |
Phone Number: | 2033252667 |
Fax Number: | 2039730446 |
NPI Enumeration Date: | 05/31/2007 |
NPI Last Update Date: | 09/11/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |