| Ellen Riccardi, Llc | |
|
1214 Post Rd Fairfield CT 06824-6008 | |
| (973) 879-8289 | |
| Not Available |
| Full Name | Ellen Riccardi, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1214 Post Rd, Fairfield, Connecticut |
| Authorized Official Name and Position | Grace Cullen (MEDICAL BILLING MANAGER) |
| Authorized Official Contact | 2033685515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen Riccardi, Llc 528 Brewster St Bridgeport CT 06605-3411 Ph: (973) 879-8289 | Ellen Riccardi, Llc 1214 Post Rd Fairfield CT 06824-6008 Ph: (973) 879-8289 |
| NPI Number | 1184270571 |
|---|---|
| Provider Enumeration Date | 08/13/2019 |
| Last Update Date | 08/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184270571 | NPI | - | NPPES |
| 004069985 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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