| West Haven Medical Group, Llc | |
|
687 Campbell Ave West Haven CT 06516-3774 | |
| (203) 932-6481 | |
| (203) 932-4051 |
| Full Name | West Haven Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 687 Campbell Ave, West Haven, Connecticut |
| Authorized Official Name and Position | Anuruddha Walaliyadda (MANAGING PARTNER) |
| Authorized Official Contact | 2039326481 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Haven Medical Group, Llc 687 Campbell Ave West Haven CT 06516-3774 Ph: (203) 932-6481 | West Haven Medical Group, Llc 687 Campbell Ave West Haven CT 06516-3774 Ph: (203) 932-6481 |
| NPI Number | 1417955923 |
|---|---|
| Provider Enumeration Date | 07/08/2005 |
| Last Update Date | 01/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417955923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 016797 (Connecticut) | Secondary |
| 207R00000X | Internal Medicine | 016636 (Connecticut) | Primary |
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