Northwest Connecticut Physicians Llc | |
895 East Main St Torrington CT 06790-3918 | |
(860) 489-1291 | |
(860) 489-1804 |
Full Name | Northwest Connecticut Physicians Llc |
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Speciality | Internal Medicine |
Location | 895 East Main St, Torrington, Connecticut |
Authorized Official Name and Position | Dennis Jay Gottfried (PARTNER) |
Authorized Official Contact | 8604891291 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northwest Connecticut Physicians Llc 895 East Main St Torrington CT 06790-3918 Ph: (860) 489-1291 | Northwest Connecticut Physicians Llc 895 East Main St Torrington CT 06790-3918 Ph: (860) 489-1291 |
NPI Number | 1396935615 |
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Provider Enumeration Date | 08/01/2007 |
Last Update Date | 06/05/2014 |
Medicare PECOS PAC ID | 0547396913 |
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Medicare Enrollment ID | O20100325000351 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396935615 | NPI | - | NPPES |
004394904 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 021448 (Connecticut) | Primary |
363LA2200X | Nurse Practitioner - Adult Health | 004854 (Connecticut) | Secondary |
Provider Name | Dennis J Gottfried |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1952322711 PECOS PAC ID: 5991831364 Enrollment ID: I20100325000381 |
Provider Name | Pamela M Cipriano |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679850408 PECOS PAC ID: 0840457974 Enrollment ID: I20120201000573 |
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