LEIF O NORDBERG MD, LLC; NPI #1043482128

Contact Information

LEIF O NORDBERG MD, LLC

2001 W MAIN ST
SUITE 155
STAMFORD, CT 06902

Phone: 203-324-4700
Fax: 203-324-5691
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center

Indicates primary specialty

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NPI Profile & details for LEIF O NORDBERG MD, LLC

NPI Number 1043482128

LBN Legal business name LEIF O NORDBERG MD, LLC

Authorized official LEIF NORDBERG - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/28/2008

Last updated 08/22/2018 - About 8 years ago

Identifiers

CT	License #	349
CT	Other	240000178	MEDICARE ID

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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