Provider Demographics
NPI:1407297203
Name:NORWALK MEDICAL GROUP
Entity Type:Organization
Organization Name:NORWALK MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEMATOLOGY - ONCOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:ZAHRAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-845-4894
Mailing Address - Street 1:24 STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3852
Mailing Address - Country:US
Mailing Address - Phone:203-845-4800
Mailing Address - Fax:203-845-4897
Practice Address - Street 1:24 STEVENS ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3852
Practice Address - Country:US
Practice Address - Phone:203-845-4800
Practice Address - Fax:203-845-4897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038431332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site