Ct Preventive Health Edge Medical PC
General Practice in Stamford, CT. Organization (NPI-2).
NPI number1972394773
StatusActive
Last updated in NPPESMay 16, 2025
Details
- NPI
- 1972394773
- Entity type
- Organization (NPI-2)
- Legal business name
- Ct Preventive Health Edge Medical PC
- Organization subpart
- No
- Enumeration date
- May 13, 2025
- Certification date
- May 16, 2025
- Last updated
- May 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
| 163WG0000X | Registered Nurse, General Practice | – | – | |
| 207R00000X | Internal Medicine | – | – | |
| 363LP2300X | Nurse Practitioner, Primary Care | – | – |
Practice location
9 W Broad St Ste 320Stamford, CT 06902-3758
Phone 917-310-5621
Mailing address
9 W Broad St Ste 320Stamford, CT 06902-3758
Authorized official
Sven Karlsson
Coo
9173105621
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