Fairfield Clinical Services LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAIRFIELD CLINICAL SERVICES LLC

Practice address

978 E Main St
Bridgeport, CT 06608-1913

Phone

(203) 549-1872

NPI assigned

Dec 1, 2021

Last updated

Dec 1, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lakshmana Pudipeddi, PHARMDNPI 1982046918

Title

Owner/Authorized User

Phone

(203) 305-6109

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lakshmana Madhusudan Pudipeddi, RPH

  • Pharmacist
  • Bridgeport, CT
  • NPI 1982046918
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1073271664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "978 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066081913",
            "telephone_number": "203-549-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "978 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066081913",
            "telephone_number": "203-549-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD CLINICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "PUDIPEDDI",
        "authorized_official_first_name": "LAKSHMANA",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED USER",
        "authorized_official_telephone_number": "203-305-6109",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Facciolo
• Amr Fadl
• Devon Marc Fagel, MD, JD
• Fairfield Alternative Health and Medicine
• Fairfield Alternative Health and Medicine, LLC
• Fairfield County Imaging
• Fairfield County Imaging
• Fairfield County Internal Medicine and Gastroenterology Associates PC
• Fairfield County Pathology Consultants, LLC
• Fairfield County Radiology

• Family Medicine Physician in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.