Black Rock Tpk Med Grp
Internal Medicine in Trumbull, Connecticut
1295733491- Practice location
- 5520 Park Ave, Suite 203, Trumbull, CT 06611-3463
- Phone
- 203-334-7400
- Fax
- 203-338-0455
- Last updated
- September 11, 2025
Black Rock Tpk Med Grp is a healthcare organization based in Trumbull, CT. Black Rock Tpk Med Grp practices in Trumbull, CT. The NPI Number for Black Rock Tpk Med Grp is 1295733491 and holds a License No. 013894 (CT). The current practice location address for Black Rock Tpk Med Grp is 5520 Park Ave, Suite 203, Trumbull, CT 06611-3463 and can be reached out via phone at 203-334-7400 and via fax at 203-338-0455.
Provider Profile Details
- NPI Number
- 1295733491
- Provider Name
- Black Rock Tpk Med Grp
- Provider Entity Type
- Organization
- Address
- 5520 Park Ave, Suite 203, Trumbull, CT 06611-3463
- Phone Number
- 203-334-7400
- Fax Number
- 203-338-0455
- Primary Taxonomy
- Internal Medicine · 207R00000X
- Organization Subpart
- No
- Authorized Official
- Elizabeth Fernandez · Office Administrator · 203-334-7400
- Provider Enumeration Date
- July 12, 2005
- Last Update Date
- September 11, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 5520 Park Ave
Suite 203
Trumbull, CT 06611-3463 - City
- Trumbull
- State
- Connecticut
- Zip
- 06611-3463
- Phone Number
- 203-334-7400
- Fax Number
- 203-338-0455
Provider Business Mailing Address Details
- Address
- 5520 Park Ave
Suite 203
Trumbull, CT 06611-3463 - City
- Trumbull
- State
- CT
- Zip
- 06611-3463
- Phone Number
- 203-334-7400
- Fax Number
- 203-338-0455
License Information
- License State (1)
- CT
- Taxonomy (1)
- Internal Medicine, Hematology & Oncology · 207RH0003X
- License Number (2)
- 013894
- License State (2)
- CT
- Taxonomy (2)
- Internal Medicine · 207R00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Black Rock Tpk Med Grp?
The NPI number of Black Rock Tpk Med Grp is 1295733491. It was assigned on July 12, 2005 and is currently active in the NPPES registry.
What is the specialty of Black Rock Tpk Med Grp?
Black Rock Tpk Med Grp is registered under the primary taxonomy Internal Medicine (code 207R00000X), licensed in CT under license number 013894.
Where does Black Rock Tpk Med Grp practice?
The practice location is 5520 Park Ave, Suite 203, Trumbull, CT 06611-3463. The office can be reached at 203-334-7400 (phone) or 203-338-0455 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1295733491 directly on the NPPES registry website.