Westside Medical Group | |
714 Chase Parkway Suite 6 Waterbury CT 06708-3939 | |
(203) 755-4577 | |
(203) 756-3628 |
Full Name | Westside Medical Group |
---|---|
Speciality | Internal Medicine |
Location | 714 Chase Parkway, Waterbury, Connecticut |
Authorized Official Name and Position | Mark Lawrence Kraus (PRESIDENT) |
Authorized Official Contact | 2037554577 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Westside Medical Group 714 Chase Parkway Suite 6 Waterbury CT 06708-3939 Ph: (203) 755-4577 | Westside Medical Group 714 Chase Parkway Suite 6 Waterbury CT 06708-3939 Ph: (203) 755-4577 |
NPI Number | 1083724967 |
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Provider Enumeration Date | 08/30/2006 |
Last Update Date | 01/23/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083724967 | NPI | - | NPPES |
004085800 | Medicaid | CT | |
50WESTSIDECT01 | Other | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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