| General Prize One Corp | |
|
1177 High Ridge Rd Stamford CT 06905-1221 | |
| (203) 321-2158 | |
| Not Available |
| Full Name | General Prize One Corp |
|---|---|
| Speciality | General Practice |
| Location | 1177 High Ridge Rd, Stamford, Connecticut |
| Authorized Official Name and Position | Evgeniy Tatarov (OWNER) |
| Authorized Official Contact | 2033212158 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| General Prize One Corp 1177 High Ridge Rd Stamford CT 06905-1221 Ph: (203) 321-2158 | General Prize One Corp 1177 High Ridge Rd Stamford CT 06905-1221 Ph: (203) 321-2158 |
| NPI Number | 1255636635 |
|---|---|
| Provider Enumeration Date | 01/17/2011 |
| Last Update Date | 01/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255636635 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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