Child And Family Agency Of Southeastern Connecticut, Inc. | |
7 Vauxhall St New London CT 06320-5711 | |
(860) 442-2797 | |
(860) 701-3776 |
Full Name | Child And Family Agency Of Southeastern Connecticut, Inc. |
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Speciality | Clinic/Center |
Location | 7 Vauxhall St, New London, Connecticut |
Authorized Official Name and Position | Lisa Baxter (CFO) |
Authorized Official Contact | 8604432896 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Child And Family Agency Of Southeastern Connecticut, Inc. 255 Hempstead St New London CT 06320-6290 Ph: (860) 443-2896 | Child And Family Agency Of Southeastern Connecticut, Inc. 7 Vauxhall St New London CT 06320-5711 Ph: (860) 442-2797 |
NPI Number | 1225797921 |
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Provider Enumeration Date | 12/10/2021 |
Last Update Date | 12/10/2021 |
Medicare PECOS PAC ID | 2163756982 |
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Medicare Enrollment ID | O20220426001904 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225797921 | NPI | - | NPPES |
1138 | Other | CT | DPH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Carly M Madore |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396012498 PECOS PAC ID: 1052536570 Enrollment ID: I20140625001650 |
Provider Name | Nancy Banasiak |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386770337 PECOS PAC ID: 6002100351 Enrollment ID: I20160809001502 |
Provider Name | Vera Borkowski |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962885244 PECOS PAC ID: 3173883014 Enrollment ID: I20180214000639 |
Provider Name | Margo L. Fugate |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1568578227 PECOS PAC ID: 4284521931 Enrollment ID: I20181019000838 |
Provider Name | Rebecca Blake Pieper |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548832355 PECOS PAC ID: 2668879586 Enrollment ID: I20210920003106 |
Provider Name | Aymi Serena Bennhoff |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720279318 PECOS PAC ID: 2961899786 Enrollment ID: I20220426002252 |
Provider Name | Jenna Gunnell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427659069 PECOS PAC ID: 2062809726 Enrollment ID: I20220427001262 |
Provider Name | Tiffany Allen Zunum |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922434489 PECOS PAC ID: 9931339462 Enrollment ID: I20220815002026 |
Provider Name | Jessica Lyn Chan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174937114 PECOS PAC ID: 5890171243 Enrollment ID: I20221007002195 |
Provider Name | Natalie Guarin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316348519 PECOS PAC ID: 1557688777 Enrollment ID: I20221027001641 |
Provider Name | Andrew Konesky |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598179640 PECOS PAC ID: 6103294459 Enrollment ID: I20221117003238 |
Provider Name | Auren Pope |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023321825 PECOS PAC ID: 9436338720 Enrollment ID: I20221219002482 |
Provider Name | Natasha Singer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457835357 PECOS PAC ID: 2961872692 Enrollment ID: I20221221001637 |
Provider Name | Marque A Setevage |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912011693 PECOS PAC ID: 5799158192 Enrollment ID: I20230306002714 |
Provider Name | Lisa Wrubel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548875776 PECOS PAC ID: 1658737812 Enrollment ID: I20230515002173 |
Child And Family Agency Of Southeastern Connecticut, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 37 Beech Dr, New London, CT 06320 Phone: 860-447-6060 Fax: 860-701-3770 | |
Child And Family Agency Of Southeastern Connecticut, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Shaw St, New London, CT 06320 Phone: 860-442-1798 | |
Child And Family Agency Of Southeastern Connecticut, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 490 Jefferson Ave, New London, CT 06320 Phone: 860-437-6400 Fax: 860-701-3771 | |
Coastal Digestive Diseases Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 234 Bank St, 4th Floor, New London, CT 06320 Phone: 860-442-0290 Fax: 860-442-2136 | |
Heritage Family Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 470 Bank St, New London, CT 06320 Phone: 860-444-9010 Fax: 860-444-9020 | |
Ledge Light Medical Assocates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 419 Montauk Ave, New London, CT 06320 Phone: 860-442-4442 Fax: 860-442-4446 |