| Mark Chuoke Llc | |
|
207 Storrs Rd Mansfield Center CT 06250-1638 | |
| (860) 481-2262 | |
| Not Available |
| Full Name | Mark Chuoke Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 207 Storrs Rd, Mansfield Center, Connecticut |
| Authorized Official Name and Position | Mark Chuoke (OWNER) |
| Authorized Official Contact | 8604811351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Chuoke Llc 265 Paine Rd Pomfret Center CT 06259-1928 Ph: (860) 481-1351 | Mark Chuoke Llc 207 Storrs Rd Mansfield Center CT 06250-1638 Ph: (860) 481-2262 |
| NPI Number | 1902464829 |
|---|---|
| Provider Enumeration Date | 06/05/2019 |
| Last Update Date | 06/05/2019 |
| Medicare PECOS PAC ID | 6507262797 |
|---|---|
| Medicare Enrollment ID | O20210914001872 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902464829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Mark Chuoke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366848616 PECOS PAC ID: 7315366028 Enrollment ID: I20210914001992 |
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