Provider Demographics
NPI:1316486970
Name:PRIMARY CARE OF WESTPORT LLC
Entity type:Organization
Organization Name:PRIMARY CARE OF WESTPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TELTSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-571-3000
Mailing Address - Street 1:333 POST RD W
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4754
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:333 POST RD W
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4754
Practice Address - Country:US
Practice Address - Phone:203-571-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty