| Id Specialists Of Fairfield, Pllc | |
|
1300 Post Rd Ste 208 Fairfield CT 06824-6038 | |
| (203) 893-0335 | |
| Not Available |
| Full Name | Id Specialists Of Fairfield, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1300 Post Rd Ste 208, Fairfield, Connecticut |
| Authorized Official Name and Position | Jo-anne Passalacqua (PHYSICIAN) |
| Authorized Official Contact | 2038930335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Id Specialists Of Fairfield, Pllc 115 Lords Hwy Weston CT 06883-1715 Ph: (203) 893-0335 | Id Specialists Of Fairfield, Pllc 1300 Post Rd Ste 208 Fairfield CT 06824-6038 Ph: (203) 893-0335 |
| NPI Number | 1154816023 |
|---|---|
| Provider Enumeration Date | 06/24/2018 |
| Last Update Date | 06/24/2018 |
| Medicare PECOS PAC ID | 9032453410 |
|---|---|
| Medicare Enrollment ID | O20181212001591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154816023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | CT035850 (Connecticut) | Primary |
| Provider Name | Joanne Passalacqua |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1710946678 PECOS PAC ID: 2567459837 Enrollment ID: I20040428000950 |
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