Integrated Wound Care Connecticut Pllc | |
930 Mill Hill Ter Southport CT 06890-1265 | |
(718) 705-6010 | |
Not Available |
Full Name | Integrated Wound Care Connecticut Pllc |
---|---|
Speciality | General Practice |
Location | 930 Mill Hill Ter, Southport, Connecticut |
Authorized Official Name and Position | Michael M Ginsburg (PRESIDENT) |
Authorized Official Contact | 7189633495 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Integrated Wound Care Connecticut Pllc 492c Cedar Ln Ste 514 Teaneck NJ 07666-1713 Ph: () - | Integrated Wound Care Connecticut Pllc 930 Mill Hill Ter Southport CT 06890-1265 Ph: (718) 705-6010 |
NPI Number | 1649778762 |
---|---|
Provider Enumeration Date | 01/23/2018 |
Last Update Date | 03/15/2018 |
Medicare PECOS PAC ID | 0042572893 |
---|---|
Medicare Enrollment ID | O20180315000678 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649778762 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | George Edward Northrop |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1760497432 PECOS PAC ID: 0345260485 Enrollment ID: I20051202000782 |
Provider Name | Raheel Shafi |
---|---|
Provider Type | Practitioner - Plastic And Reconstructive Surgery |
Provider Identifiers | NPI Number: 1477759397 PECOS PAC ID: 3870646359 Enrollment ID: I20090730000550 |
Provider Name | Scott Herman |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1396770145 PECOS PAC ID: 9739220781 Enrollment ID: I20100113000027 |
Provider Name | Karen Terwilliger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245616705 PECOS PAC ID: 0446569719 Enrollment ID: I20151028000314 |
Provider Name | Diane Lusas |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1730475658 PECOS PAC ID: 9032430640 Enrollment ID: I20160519001057 |
Provider Name | Alla Kirzon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952841199 PECOS PAC ID: 7012292865 Enrollment ID: I20170320000204 |
Provider Name | Carrie M Reynolds |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1336571843 PECOS PAC ID: 8325282551 Enrollment ID: I20191121001860 |
Provider Name | Krystl G Ortiz |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1750649810 PECOS PAC ID: 4284030990 Enrollment ID: I20210903002000 |
Provider Name | Lutfullah Baskoy |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1386105005 PECOS PAC ID: 9830421494 Enrollment ID: I20210907001154 |
Provider Name | Kevin T Haines |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1295295137 PECOS PAC ID: 1759774706 Enrollment ID: I20220215001607 |
Progressive Care Medical Group Of Ct, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 917 Mill Hill Ter, Southport, CT 06890 Phone: 203-204-3012 |