Provider Demographics
NPI:1447656079
Name:COMPLETE HEALTH LLC
Entity type:Organization
Organization Name:COMPLETE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOATENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-913-0950
Mailing Address - Street 1:4699 MAIN ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-1830
Mailing Address - Country:US
Mailing Address - Phone:203-913-0950
Mailing Address - Fax:
Practice Address - Street 1:4699 MAIN ST
Practice Address - Street 2:SUITE 211
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-1830
Practice Address - Country:US
Practice Address - Phone:203-913-0950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045811207R00000X, 173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty