Provider Demographics
NPI:1609856178
Name:U.S. HEALTHWORKS MEDICAL GROUP OF CONNECTICUT, INC.
Entity Type:Organization
Organization Name:U.S. HEALTHWORKS MEDICAL GROUP OF CONNECTICUT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-772-6282
Mailing Address - Street 1:3655 N POINT PKWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-2025
Mailing Address - Country:US
Mailing Address - Phone:770-772-6282
Mailing Address - Fax:
Practice Address - Street 1:144 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3044
Practice Address - Country:US
Practice Address - Phone:203-481-0818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty