| Black Rock Tpk Med Grp | |
|
5520 Park Ave Suite 203 Trumbull CT 06611-3463 | |
| (203) 334-7400 | |
| (203) 338-0455 |
| Full Name | Black Rock Tpk Med Grp |
|---|---|
| Speciality | Internal Medicine - Hematology & Oncology |
| Location | 5520 Park Ave, Trumbull, Connecticut |
| Authorized Official Name and Position | Elizabeth Fernandez (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 2033347400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Rock Tpk Med Grp 5520 Park Ave Suite 203 Trumbull CT 06611-3463 Ph: (203) 334-7400 | Black Rock Tpk Med Grp 5520 Park Ave Suite 203 Trumbull CT 06611-3463 Ph: (203) 334-7400 |
| NPI Number | 1295733491 |
|---|---|
| Provider Enumeration Date | 07/12/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295733491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 013894 (Connecticut) | Primary |
| 207RH0003X | Internal Medicine - Hematology & Oncology | (Connecticut) | Primary |
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