| Connecticut Primary Care And Wellness Pc | |
|
530 Middlebury Rd Ste 103a Middlebury CT 06762-2547 | |
| (203) 527-6953 | |
| (203) 528-4331 |
| Full Name | Connecticut Primary Care And Wellness Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 530 Middlebury Rd Ste 103a, Middlebury, Connecticut |
| Authorized Official Name and Position | Ines Zemaitis (NP/CEO) |
| Authorized Official Contact | 2037686770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Connecticut Primary Care And Wellness Pc 530 Middlebury Rd Ste 103a Middlebury CT 06762-2547 Ph: (203) 527-6953 | Connecticut Primary Care And Wellness Pc 530 Middlebury Rd Ste 103a Middlebury CT 06762-2547 Ph: (203) 527-6953 |
| NPI Number | 1407378946 |
|---|---|
| Provider Enumeration Date | 07/15/2017 |
| Last Update Date | 10/09/2024 |
| Medicare PECOS PAC ID | 3779857727 |
|---|---|
| Medicare Enrollment ID | O20170914002857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407378946 | NPI | - | NPPES |
| 008075293 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Ami S Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154331015 PECOS PAC ID: 3375506694 Enrollment ID: I20041108001061 |
| Provider Name | Ines M Zemaitis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821263328 PECOS PAC ID: 9133291032 Enrollment ID: I20080710000025 |
| Provider Name | Diadette I Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396035382 PECOS PAC ID: 4183800865 Enrollment ID: I20110513000135 |
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Justin D. Caskey, D.o., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 819 Straits Tpke, Middlebury, CT 06762 Phone: 203-758-1765 Fax: 203-577-2116 |