Provider Demographics
NPI:1407255847
Name:SUPERIOR ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:SUPERIOR ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUBOULIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-309-5399
Mailing Address - Street 1:106 NOROTON AVE
Mailing Address - Street 2:INFUSION
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820
Mailing Address - Country:US
Mailing Address - Phone:203-309-5399
Mailing Address - Fax:203-656-1416
Practice Address - Street 1:106 NOROTON AVE
Practice Address - Street 2:INFUSION
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820
Practice Address - Country:US
Practice Address - Phone:203-309-5399
Practice Address - Fax:203-656-1416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Single Specialty