| Colchester Family Medicine Llc | |
|
123 Broadway St Colchester CT 06415-1022 | |
| (860) 537-3204 | |
| (860) 537-3208 |
| Full Name | Colchester Family Medicine Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 123 Broadway St, Colchester, Connecticut |
| Authorized Official Name and Position | Olawale Ayeni (PHYSICIAN/OWNER) |
| Authorized Official Contact | 8605373204 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colchester Family Medicine Llc 123 Broadway St P.o. Box 288 Colchester CT 06415-1022 Ph: (860) 537-3204 | Colchester Family Medicine Llc 123 Broadway St Colchester CT 06415-1022 Ph: (860) 537-3204 |
| NPI Number | 1952596579 |
|---|---|
| Provider Enumeration Date | 09/06/2007 |
| Last Update Date | 08/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952596579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 041093 (* (Not Available)) | Primary |
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