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Contact Information

GREENWICH MEDICAL GROUP
75 HOLLY HILL LN
GREENWICH, CT06830-6098
 Phone: 203-869-6960
 Fax: 203-869-5103
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for GREENWICH MEDICAL GROUP

NPI Number 1881781029
LBN Legal business name GREENWICH MEDICAL GROUP
Authorized official GAIL FENNELL - (MANAGING PARTNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/09/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
CT License # AA2470348
CT License # AM6000715
CT License # AS8735308
CT License # BF4323503
CT License # BL9582493
CT License # BN3275369
CT License # BV5838959
CT Medicaid 00439394R
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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