| Infectious Disease Specialists Of Connecticut, Llc | |
|
2660 Main St Suite 221 Bridgeport CT 06606-5369 | |
| (203) 659-1599 | |
| (203) 659-1599 |
| Full Name | Infectious Disease Specialists Of Connecticut, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2660 Main St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Grace P. Kim (MEMBER) |
| Authorized Official Contact | 2036591599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease Specialists Of Connecticut, Llc Po Box 797 Wilton CT 06897-0797 Ph: (203) 659-1599 | Infectious Disease Specialists Of Connecticut, Llc 2660 Main St Suite 221 Bridgeport CT 06606-5369 Ph: (203) 659-1599 |
| NPI Number | 1336374339 |
|---|---|
| Provider Enumeration Date | 05/19/2009 |
| Last Update Date | 08/18/2022 |
| Medicare PECOS PAC ID | 7113078866 |
|---|---|
| Medicare Enrollment ID | O20090619000431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336374339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 031353 (Connecticut) | Primary |
| Provider Name | Grace Kim |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1720036700 PECOS PAC ID: 2466463716 Enrollment ID: I20070721000009 |
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