| Phoenix Psychiatry Llc | |
|
254 Burnside Ave Ste 4 East Hartford CT 06108-2367 | |
| (860) 780-4313 | |
| Not Available |
| Full Name | Phoenix Psychiatry Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 254 Burnside Ave Ste 4, East Hartford, Connecticut |
| Authorized Official Name and Position | Anthea Mendez (OWNER) |
| Authorized Official Contact | 8607804313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Psychiatry Llc 254 Burnside Ave Ste 4 East Hartford CT 06108-2367 Ph: (860) 780-4313 | Phoenix Psychiatry Llc 254 Burnside Ave Ste 4 East Hartford CT 06108-2367 Ph: (860) 780-4313 |
| NPI Number | 1396463303 |
|---|---|
| Provider Enumeration Date | 08/16/2022 |
| Last Update Date | 08/16/2022 |
| Medicare PECOS PAC ID | 1456737527 |
|---|---|
| Medicare Enrollment ID | O20220928000683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396463303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 363LA2100X | Nurse Practitioner - Acute Care | (* (Not Available)) | Secondary |
| Provider Name | Anthea Mendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912194796 PECOS PAC ID: 6800986746 Enrollment ID: I20071217000206 |
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