| Sf Connecticut Medical Services Pc | |
|
2798 Whitney Ave Hamden CT 06518-2554 | |
| (877) 258-6331 | |
| (718) 414-1651 |
| Full Name | Sf Connecticut Medical Services Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2798 Whitney Ave, Hamden, Connecticut |
| Authorized Official Name and Position | Simon Fensterszaub (OWNER) |
| Authorized Official Contact | 2127346621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sf Connecticut Medical Services Pc 228 E Route 59 # 408 Nanuet NY 10954-2905 Ph: (718) 362-1411 | Sf Connecticut Medical Services Pc 2798 Whitney Ave Hamden CT 06518-2554 Ph: (877) 258-6331 |
| NPI Number | 1841758729 |
|---|---|
| Provider Enumeration Date | 03/09/2019 |
| Last Update Date | 01/19/2023 |
| Medicare PECOS PAC ID | 9830430297 |
|---|---|
| Medicare Enrollment ID | O20190411001677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841758729 | NPI | - | NPPES |
| 62202 | Other | CT | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Simon Fensterszaub |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003077322 PECOS PAC ID: 5890970230 Enrollment ID: I20190411001855 |
| Provider Name | Gina Choiniere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538718861 PECOS PAC ID: 8123359577 Enrollment ID: I20191016000690 |
| Provider Name | Elizabeth Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073051827 PECOS PAC ID: 9133406713 Enrollment ID: I20200501001304 |
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