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Contact Information

THE GREENWICH MEDICAL GROUP
75 HOLLY HILL LN
GREENWICH, CT06830-6098
 Phone: 203-869-6960
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Medical

363AM0700X 97 Physician Assistant
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for THE GREENWICH MEDICAL GROUP

NPI Number 1558436766
LBN Legal business name THE GREENWICH MEDICAL GROUP
Authorized official STUART MCCALLEY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/22/2006
Last updated 06/17/2009 - About 17 years ago
Identifiers
CT License # 001163
CT Medicaid 004393948
CT Other 471501 AETNA HMO GROUP NUMBER
CT Other 8170815 AETNA PPO GROUP NUMBER
CT Other C30447 RAILROAD MEDICARE GROUP #
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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