Provider Demographics
NPI:1811167364
Name:ACCUMEDICA, LLC
Entity type:Organization
Organization Name:ACCUMEDICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-372-9982
Mailing Address - Street 1:2660 MAIN ST
Mailing Address - Street 2:SUITE 219
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-5369
Mailing Address - Country:US
Mailing Address - Phone:203-372-9982
Mailing Address - Fax:203-366-4008
Practice Address - Street 1:2660 MAIN ST
Practice Address - Street 2:SUITE 219
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-5369
Practice Address - Country:US
Practice Address - Phone:203-372-9982
Practice Address - Fax:203-366-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty