| Preventative Healthcare Solutions Llc | |
|
1187 Broad St Lower Level Bridgeport CT 06604-4101 | |
| (203) 870-8008 | |
| (203) 330-8007 |
| Full Name | Preventative Healthcare Solutions Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1187 Broad St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Noel H Sepulveda (OWNER) |
| Authorized Official Contact | 2038708008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Preventative Healthcare Solutions Llc 1187 Broad St Lower Level Bridgeport CT 06604-4101 Ph: (203) 870-8008 | Preventative Healthcare Solutions Llc 1187 Broad St Lower Level Bridgeport CT 06604-4101 Ph: (203) 870-8008 |
| NPI Number | 1528434115 |
|---|---|
| Provider Enumeration Date | 08/18/2015 |
| Last Update Date | 01/08/2019 |
| Medicare PECOS PAC ID | 3375844566 |
|---|---|
| Medicare Enrollment ID | O20151211001623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528434115 | NPI | - | NPPES |
| D100262848 | Other | CT | MEDICARE PTAN |
| Provider Name | Elba I Crespo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669528774 PECOS PAC ID: 7719979236 Enrollment ID: I20040402000177 |
| Provider Name | Noel H Sepulveda |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1831477975 PECOS PAC ID: 7618278805 Enrollment ID: I20151211001832 |
| Provider Name | Dwayne Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013624535 PECOS PAC ID: 7719357060 Enrollment ID: I20221230000989 |
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