| Fsw | |
|
475 Clinton Ave Bridgeport CT 06605-1700 | |
| (203) 368-4291 | |
| (203) 368-1239 |
| Full Name | Fsw |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 475 Clinton Ave, Bridgeport, Connecticut |
| Authorized Official Name and Position | Frank Farias (CHIEF FINANCIAL & HR OFFICER) |
| Authorized Official Contact | 2033684291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fsw 475 Clinton Ave Bridgeport CT 06605-1700 Ph: (203) 368-4291 | Fsw 475 Clinton Ave Bridgeport CT 06605-1700 Ph: (203) 368-4291 |
| NPI Number | 1568679967 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 11/18/2020 |
| Certification Date | 11/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568679967 | NPI | - | NPPES |
| C01300 | Other | CT | GRP# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 000201 (Connecticut) | Primary |
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