| Masonicare Health Center | |
|
22 Masonic Ave Wallingford CT 06492-3048 | |
| (203) 679-5900 | |
| Not Available |
| Full Name | Masonicare Health Center |
|---|---|
| Speciality | Chronic Disease Hospital |
| Location | 22 Masonic Ave, Wallingford, Connecticut |
| Authorized Official Name and Position | Jon-paul Venoit (PRESIDENT & CEO) |
| Authorized Official Contact | 2036795000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Masonicare Health Center 22 Masonic Ave Wallingford CT 06492-3048 Ph: (203) 679-5900 | Masonicare Health Center 22 Masonic Ave Wallingford CT 06492-3048 Ph: (203) 679-5900 |
| NPI Number | 1629061593 |
|---|---|
| Provider Enumeration Date | 08/25/2005 |
| Last Update Date | 11/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629061593 | NPI | - | NPPES |
| 004025425 | Medicaid | CT | |
| 082 | Other | CT | BLUE CROSS |
| 000070177 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 0075 (Connecticut) | Secondary |
| 281P00000X | Chronic Disease Hospital | 11CD (Connecticut) | Primary |
Complete Wound Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 67 Masonic Ave Ste 2400, Wallingford, CT 06492 Phone: 203-408-2462 | |
Bennett Family Chiropractic, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 950 Yale Ave, Suite 29, Wallingford, CT 06492 Phone: 203-793-7147 Fax: 203-793-7214 | |
Finesse Health, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 53 Parker St Apt F216, Wallingford, CT 06492 Phone: 516-567-9738 | |
Reza Moien Md Internal Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 850 N Main Street Ext, Building#1, Suite D2, Wallingford, CT 06492 Phone: 203-265-0298 Fax: 203-265-0361 | |
Equal Health Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 185 Center Street, Suite 2a, Wallingford, CT 06492 Phone: 203-679-0055 Fax: 203-679-0060 |