Mystic Geriatrics, Llc | |
3 Heron Rd Mystic CT 06355-3253 | |
(860) 536-5302 | |
(860) 536-5302 |
Full Name | Mystic Geriatrics, Llc |
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Speciality | Family Medicine |
Location | 3 Heron Rd, Mystic, Connecticut |
Authorized Official Name and Position | June Fliri (MANAGER) |
Authorized Official Contact | 8605368882 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mystic Geriatrics, Llc 3 Heron Rd Mystic CT 06355-3253 Ph: (860) 536-5302 | Mystic Geriatrics, Llc 3 Heron Rd Mystic CT 06355-3253 Ph: (860) 536-5302 |
NPI Number | 1336167238 |
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Provider Enumeration Date | 07/18/2006 |
Last Update Date | 07/20/2015 |
Medicare PECOS PAC ID | 0547578841 |
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Medicare Enrollment ID | O20151007000652 |
Identifier | Type | State | Issuer |
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1336167238 | NPI | - | NPPES |
Provider Name | Michael J Feltes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689690216 PECOS PAC ID: 2567410707 Enrollment ID: I20100331000249 |
Provider Name | Karen Terwilliger |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245616705 PECOS PAC ID: 0446569719 Enrollment ID: I20151028000314 |
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