Provider Demographics
NPI:1679761233
Name:FIRST AID IMMEDIATE CARE MEDICAL CENTER
Entity Type:Organization
Organization Name:FIRST AID IMMEDIATE CARE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:ZANGRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-261-6111
Mailing Address - Street 1:900 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611
Mailing Address - Country:US
Mailing Address - Phone:203-261-6111
Mailing Address - Fax:
Practice Address - Street 1:900 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-5727
Practice Address - Country:US
Practice Address - Phone:203-261-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC00768Medicare PIN