Prime Weight Loss Llc | |
2 Independence Cir Southbury CT 06488-3001 | |
(475) 777-6912 | |
Not Available |
Full Name | Prime Weight Loss Llc |
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Speciality | Internal Medicine |
Location | 2 Independence Cir, Southbury, Connecticut |
Authorized Official Name and Position | Emir Khattak (MANAGER) |
Authorized Official Contact | 4699154211 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Prime Weight Loss Llc 2 Independence Cir Southbury CT 06488-3001 Ph: (475) 777-6912 | Prime Weight Loss Llc 2 Independence Cir Southbury CT 06488-3001 Ph: (475) 777-6912 |
NPI Number | 1356182430 |
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Provider Enumeration Date | 06/04/2024 |
Last Update Date | 06/04/2024 |
Medicare PECOS PAC ID | 0648716233 |
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Medicare Enrollment ID | O20240718004428 |
Identifier | Type | State | Issuer |
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1356182430 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Aisha Khan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1265939540 PECOS PAC ID: 1658776885 Enrollment ID: I20210825003123 |
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