Stamford Health-Norwalk Radiology LLC

Organization Active NPI Diagnostic Radiology Physician · Norwalk, CT

NPI 1508545211 · NPPES record last updated Jan 31, 2024

Key facts

NPI
1508545211
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
Legal business name
STAMFORD HEALTH-NORWALK RADIOLOGY LLC
Practice address
148 East Ave Ste 1M
Norwalk, CT 06851-5721
Phone
(203) 276-4311
NPI assigned
Jul 12, 2023
Organization subpart
No

Authorized official

Name
Elizabeth Longmore
Title
President
Phone
(203) 276-7931

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CT, NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240221004071 CT Part B Supplier - Clinic/Group Practice 6709220320 Receives reassigned benefits from 19 practitioners
Practice locations: New Canaan, CT; Norwalk, CT
O20251208000125 NY Part B Supplier - Clinic/Group Practice 6709220320 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY; Scarsdale, NY

National Provider Directory

Locations

148 East Ave
Ste 1M
Norwalk, CT 06851
Phone (203) 276-4311

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2085R0202X Yes

Addresses

Primary practice location

148 East Ave Ste 1M
Norwalk, CT 06851-5721

Mailing address

148 East Ave Ste 1M
Norwalk, CT 06851-5721
Phone (203) 276-4311

Other providers in Norwalk, CT

All providers in Norwalk, CT · Diagnostic Radiology Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.