General Prize One Corp

NPI #1255636635 in Stamford, Connecticut

Provider Information

NPI Number: 1255636635
Entity Type: Organization
Organization Name: General Prize One Corp
Primary Specialty: General Practice
Enumeration Date: Jan 17, 2011
Last Updated: Jan 17, 2011

Practice Location

Address: 1177 HIGH RIDGE RD
City: Stamford
State: Connecticut
ZIP Code: 06905-1221
Phone: (203) 321-2158

Authorized Official

Name: EVGENIY TATAROV
Title: OWNER
Phone: (203) 321-2158

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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