Provider Demographics
NPI:1225170418
Name:CHARLES G. HEMENWAY JR., M.D. P.C.
Entity Type:Organization
Organization Name:CHARLES G. HEMENWAY JR., M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-256-9249
Mailing Address - Street 1:111 BEACH RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6668
Mailing Address - Country:US
Mailing Address - Phone:203-256-9249
Mailing Address - Fax:203-256-0760
Practice Address - Street 1:111 BEACH RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6668
Practice Address - Country:US
Practice Address - Phone:203-256-9249
Practice Address - Fax:203-256-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0406702080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty