Provider Demographics
NPI:1316978349
Name:VILLAGE MEDICAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:VILLAGE MEDICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BJORN
Authorized Official - Middle Name:
Authorized Official - Last Name:RINGSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-865-6400
Mailing Address - Street 1:12 VILLAGE STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473
Mailing Address - Country:US
Mailing Address - Phone:203-865-6400
Mailing Address - Fax:203-865-0195
Practice Address - Street 1:12 VILLAGE STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473
Practice Address - Country:US
Practice Address - Phone:203-865-6400
Practice Address - Fax:203-865-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT020407207R00000X
CT038423207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty