Provider Demographics
NPI:1104245794
Name:CLL HEALTH CARE CLINIC, LLC
Entity type:Organization
Organization Name:CLL HEALTH CARE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:ZHENXIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-271-7089
Mailing Address - Street 1:527 W THAMES ST
Mailing Address - Street 2:UNIT 23
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-7153
Mailing Address - Country:US
Mailing Address - Phone:203-271-7089
Mailing Address - Fax:
Practice Address - Street 1:527 W THAMES ST
Practice Address - Street 2:UNIT 23
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-7153
Practice Address - Country:US
Practice Address - Phone:203-271-7089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048768261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health