| Primary Care Of Shelton Llc | |
|
555 Bridgeport Ave Shelton CT 06484-4749 | |
| (203) 225-0506 | |
| Not Available |
| Full Name | Primary Care Of Shelton Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 555 Bridgeport Ave, Shelton, Connecticut |
| Authorized Official Name and Position | Bardia Asgari (CEO) |
| Authorized Official Contact | 2032250506 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Of Shelton Llc 555 Bridgeport Ave Shelton CT 06484-4749 Ph: (203) 225-0506 | Primary Care Of Shelton Llc 555 Bridgeport Ave Shelton CT 06484-4749 Ph: (203) 225-0506 |
| NPI Number | 1700927720 |
|---|---|
| Provider Enumeration Date | 02/11/2007 |
| Last Update Date | 09/15/2008 |
| Medicare PECOS PAC ID | 0840394292 |
|---|---|
| Medicare Enrollment ID | O20070326000059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700927720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 038488 (Connecticut) | Primary |
| Provider Name | Bardia Asgari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811938533 PECOS PAC ID: 2163526260 Enrollment ID: I20070329000470 |
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