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92 Connecticut Boulevard East Hartford CT 06108 | |
(860) 610-6131 | |
(860) 290-4142 |
Full Name | |
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Speciality | Clinic/Center |
Location | 92 Connecticut Boulevard, East Hartford, Connecticut |
Authorized Official Name and Position | Eugene A Market (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 8606106131 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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94 Connecticut Boulevard East Hartford CT 06108-3013 Ph: (860) 610-6131 | 92 Connecticut Boulevard East Hartford CT 06108 Ph: (860) 610-6131 |
NPI Number | 1770932642 |
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Provider Enumeration Date | 06/10/2016 |
Last Update Date | 03/16/2017 |
Medicare PECOS PAC ID | 2769417609 |
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Medicare Enrollment ID | O20160719000032 |
Identifier | Type | State | Issuer |
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1770932642 | NPI | - | NPPES |
004236164 | Medicaid | CT |
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