| Fairfield Clinical Services LLC | |
|
978 E Main St Bridgeport CT 06608-1913 | |
| (203) 549-1872 | |
| Not Available |
| Full Name | Fairfield Clinical Services LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 978 E Main St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Lakshmana Pudipeddi (OWNER/AUTHORIZED USER) |
| Authorized Official Contact | 2033056109 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfield Clinical Services LLC 978 E Main St Bridgeport CT 06608-1913 Ph: (203) 549-1872 | Fairfield Clinical Services LLC 978 E Main St Bridgeport CT 06608-1913 Ph: (203) 549-1872 |
| NPI Number | 1073271664 |
|---|---|
| Provider Enumeration Date | 12/01/2021 |
| Last Update Date | 12/01/2021 |
| Certification Date | 12/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073271664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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