| Gary Blick Md | |
|
2595 Main St Stratford CT 06615-5855 | |
| (203) 345-0404 | |
| (203) 908-4110 |
| Full Name | Gary Blick Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 2595 Main St, Stratford, Connecticut |
| Authorized Official Name and Position | Gary Blick (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 2033450404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary Blick Md 2595 Main St Stratford CT 06615-5855 Ph: (203) 345-0404 | Gary Blick Md 2595 Main St Stratford CT 06615-5855 Ph: (203) 345-0404 |
| NPI Number | 1003353442 |
|---|---|
| Provider Enumeration Date | 01/24/2017 |
| Last Update Date | 01/08/2024 |
| Medicare PECOS PAC ID | 7810271335 |
|---|---|
| Medicare Enrollment ID | O20170301001524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003353442 | NPI | - | NPPES |
| 001275247 | Medicaid | CT | |
| 02555264 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 027524 (Connecticut) | Secondary |
| 207RI0200X | Internal Medicine - Infectious Disease | 027524 (Connecticut) | Primary |
| Provider Name | Gary Blick |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1598837957 PECOS PAC ID: 2961672886 Enrollment ID: I20110901000747 |
| Provider Name | Elysia Cerreta-dial |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639694441 PECOS PAC ID: 7810262771 Enrollment ID: I20171004000212 |
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