Provider Demographics
NPI:1245249549
Name:MILL HILL MEDICAL CONSULTANTS INC
Entity type:Organization
Organization Name:MILL HILL MEDICAL CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-384-3717
Mailing Address - Street 1:77 LAFAYETTE PL
Mailing Address - Street 2:SUITE 302
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5426
Mailing Address - Country:US
Mailing Address - Phone:203-863-4250
Mailing Address - Fax:203-863-4249
Practice Address - Street 1:77 LAFAYETTE PL
Practice Address - Street 2:SUITE 302
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5426
Practice Address - Country:US
Practice Address - Phone:203-863-4250
Practice Address - Fax:203-863-4249
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREAST CARE SERVICES OF GREENWICH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-05
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03085OtherMEDICARE GROUP NUMBER