Provider Demographics
NPI:1710058631
Name:BAGINSKI MEDICAL LLC
Entity Type:Organization
Organization Name:BAGINSKI MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PIOTR
Authorized Official - Middle Name:WALDEMAR
Authorized Official - Last Name:BAGINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-944-9775
Mailing Address - Street 1:3 HICKORY LANE
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06403
Mailing Address - Country:US
Mailing Address - Phone:203-734-1617
Mailing Address - Fax:203-735-2614
Practice Address - Street 1:4 CORPORATE DR
Practice Address - Street 2:SUITE 283
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6211
Practice Address - Country:US
Practice Address - Phone:203-944-9775
Practice Address - Fax:203-944-9964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039585207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty