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Contact Information

BLACK ROCK TPK MED GRP
5520 PARK AVE
SUITE 203
TRUMBULL, CT06611-3463
 Phone: 203-334-7400
 Fax: 203-338-0455
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for BLACK ROCK TPK MED GRP

NPI Number 1295733491
LBN Legal business name BLACK ROCK TPK MED GRP
Authorized official ELIZABETH FERNANDEZ - (OFFICE ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/12/2005
Last updated 09/11/2025 - About 9 months ago
Identifiers
CT License # 013894
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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