| Primary Care And Behavioral Health Services | |
|
2880 Old Dixwell Ave Ste 200 Hamden CT 06518-3144 | |
| (203) 848-1803 | |
| Not Available |
| Full Name | Primary Care And Behavioral Health Services |
|---|---|
| Speciality | Internal Medicine |
| Location | 2880 Old Dixwell Ave Ste 200, Hamden, Connecticut |
| Authorized Official Name and Position | Margaret Chustecka (MANAGING MEMBER) |
| Authorized Official Contact | 2038481803 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care And Behavioral Health Services 2880 Dixwell Ave Suit 200 Hamden CT 06518-3128 Ph: (203) 848-1803 | Primary Care And Behavioral Health Services 2880 Old Dixwell Ave Ste 200 Hamden CT 06518-3144 Ph: (203) 848-1803 |
| NPI Number | 1821737313 |
|---|---|
| Provider Enumeration Date | 06/02/2022 |
| Last Update Date | 02/08/2023 |
| Medicare PECOS PAC ID | 8628458213 |
|---|---|
| Medicare Enrollment ID | O20220628003330 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821737313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Marc D Legris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114935723 PECOS PAC ID: 6305906322 Enrollment ID: I20081120000798 |
| Provider Name | Farhad Montazeri-lemraski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306136957 PECOS PAC ID: 8820414576 Enrollment ID: I20200806001974 |
| Provider Name | Samuel Frimpong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972919603 PECOS PAC ID: 0547488306 Enrollment ID: I20240521000608 |
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