| Epiphany Medical Services, Pc | |
|
2440 Whitney Ave Hamden CT 06518-3222 | |
| (203) 389-5606 | |
| Not Available |
| Full Name | Epiphany Medical Services, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2440 Whitney Ave, Hamden, Connecticut |
| Authorized Official Name and Position | Paul Kevin Clarke (DIRECTOR/OWNER) |
| Authorized Official Contact | 2033895606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Epiphany Medical Services, Pc 531 Overland Dr Orange CT 06477-2655 Ph: (203) 492-9395 | Epiphany Medical Services, Pc 2440 Whitney Ave Hamden CT 06518-3222 Ph: (203) 389-5606 |
| NPI Number | 1356840466 |
|---|---|
| Provider Enumeration Date | 02/04/2018 |
| Last Update Date | 03/06/2019 |
| Medicare PECOS PAC ID | 0547503559 |
|---|---|
| Medicare Enrollment ID | O20190515000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356840466 | NPI | - | NPPES |
| 001390385 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Paul K Clarke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548292279 PECOS PAC ID: 0143412197 Enrollment ID: I20101008000166 |
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