Geriatric Professional Group, Llc

LBN: Geriatric Professional Group, Llc
Geriatric Professional Group, Llc is an health care organization with primary practice located at 4200 Park Ave , Bridgeport CT 06604-1049. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Geriatric Professional Group, Llc can be contacted via phone (203) 365-6473, or through Banoff, Andrew H via phone (203) 365-6400.

Contact Information

Primary practice address
4200 Park Ave Bridgeport CT 06604-1049
Phone: (203) 365-6473
Fax: (203) 396-1039
Website:
Map and Directions
Authorized official contact:
Name: Banoff, Andrew H
Phone: (203) 365-6400

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X Connecticut

Profile Details

NPI number 1932295953
LBN Legal business name Geriatric Professional Group, Llc
DBA Doing business as
Authorized official Banoff, Andrew H
Entity Organization
Organization subpart 1 No
Enumeration date Oct 5th, 2006
Last updated Nov 7th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932295953 NPPES
Connecticut MEDICAID 9233

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