| Kerith Brook Cfc | |
|
27 Patriots Sq Mansfield Center CT 06250-1517 | |
| (860) 752-4249 | |
| Not Available |
| Full Name | Kerith Brook Cfc |
|---|---|
| Speciality | Clinic/Center |
| Location | 27 Patriots Sq, Mansfield Center, Connecticut |
| Authorized Official Name and Position | Michael Rivera (OWNER) |
| Authorized Official Contact | 6075244249 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kerith Brook Cfc 27 Patriots Sq Mansfield Center CT 06250-1517 Ph: () - | Kerith Brook Cfc 27 Patriots Sq Mansfield Center CT 06250-1517 Ph: (860) 752-4249 |
| NPI Number | 1932851102 |
|---|---|
| Provider Enumeration Date | 01/19/2022 |
| Last Update Date | 01/19/2022 |
| Medicare PECOS PAC ID | 7416322862 |
|---|---|
| Medicare Enrollment ID | O20230417002121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932851102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jeanne C Percy-rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255809125 PECOS PAC ID: 0345581070 Enrollment ID: I20190408000886 |
| Provider Name | Theresa Antwi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053081398 PECOS PAC ID: 1052793668 Enrollment ID: I20220728003570 |
| Provider Name | Peta Lawson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033870365 PECOS PAC ID: 4183060619 Enrollment ID: I20240307000199 |
| Provider Name | Eric Stillman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942793344 PECOS PAC ID: 4587004692 Enrollment ID: I20240506003134 |
Ledgebrook Family Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 Ledgebrook Dr, Suite A, Mansfield Center, CT 06250 Phone: 860-456-1485 Fax: 860-423-1589 | |
Ralph J. Laguardia, M.d, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10 Higgins Hwy, Suite 4, Mansfield Center, CT 06250 Phone: 860-456-7101 Fax: 860-423-0464 |