Provider Demographics
NPI:1295731909
Name:CITY OF MERIDEN-HEALTH DEPARTMETN
Entity type:Organization
Organization Name:CITY OF MERIDEN-HEALTH DEPARTMETN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:DELBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-630-4234
Mailing Address - Street 1:165 MILLER ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-4256
Mailing Address - Country:US
Mailing Address - Phone:203-630-4221
Mailing Address - Fax:203-639-0039
Practice Address - Street 1:165 MILLER ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-4256
Practice Address - Country:US
Practice Address - Phone:203-630-4221
Practice Address - Fax:203-639-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009654173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty