NPI 1457793291

Mgda

Organisation Preferred Provider Organization Waterbury, CT

Practice location

Address: 146 Highland Ave, Waterbury, CT 06708-2761
Phone: (203) 755-7748
Fax: (203) 755-7784

Authorised official

Name: Michael Greenwald
Title: Owner
Phone: (203) 755-7748

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 007481 (CT)

Other Preferred Provider Organization providers in Connecticut →

Registry record

NPI: 1457793291
Entity type: Organization
NPI issued: 22 Jul 2013
Record last updated: 22 Jul 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.