| Family Practice Of Greater New Haven, Llc | |
|
850 N Main Street Ext Building 2 Suite 1b Wallingford CT 06492-2400 | |
| (203) 269-4200 | |
| (203) 269-8800 |
| Full Name | Family Practice Of Greater New Haven, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 850 N Main Street Ext, Wallingford, Connecticut |
| Authorized Official Name and Position | Anatoly Braylovsky (PHYSICIAN/ OWNER) |
| Authorized Official Contact | 2032694200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice Of Greater New Haven, Llc 850 N Main Street Ext Building 2 Suite 1b Wallingford CT 06492-2400 Ph: (203) 269-4200 | Family Practice Of Greater New Haven, Llc 850 N Main Street Ext Building 2 Suite 1b Wallingford CT 06492-2400 Ph: (203) 269-4200 |
| NPI Number | 1922114495 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 12/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922114495 | NPI | - | NPPES |
| 001409516 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 040951 (Connecticut) | Primary |
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