| D/b/a Greenwich Family Practice & Pain Management Center | |
|
49 Lake Avenue Suite Ll4 Greenwich CT 06830 | |
| (203) 552-9037 | |
| (203) 552-9048 |
| Full Name | D/b/a Greenwich Family Practice & Pain Management Center |
|---|---|
| Speciality | Family Medicine |
| Location | 49 Lake Avenue, Greenwich, Connecticut |
| Authorized Official Name and Position | Manami Sekiguchi (VICE PRESIDENT/SECRETARY) |
| Authorized Official Contact | 2035529037 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| D/b/a Greenwich Family Practice & Pain Management Center 49 Lake Avenue Suite Ll4 Greenwich CT 06830 Ph: (203) 552-9037 | D/b/a Greenwich Family Practice & Pain Management Center 49 Lake Avenue Suite Ll4 Greenwich CT 06830 Ph: (203) 552-9037 |
| NPI Number | 1326211244 |
|---|---|
| Provider Enumeration Date | 04/11/2008 |
| Last Update Date | 05/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326211244 | NPI | - | NPPES |
| P512831 | Other | CT | OXFORD |
| 086934 | Other | CT | AETNA |
| 010035655CT01 | Other | CT | ANTHEM |
| 220195293 | Other | CT | GUARDIAN |
| 22019529300 | Other | OH | OHIO BWC |
| 584648 | Other | CT | AETNA |
| 021058 | Other | CT | HEALTHNET |
| 035665 | Other | CT | CONNECTICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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