Southeastern Ct Primary Care, Llc | |
495 Gold Star Hwy Ste 112 Groton CT 06340-6229 | |
(860) 691-8084 | |
(860) 691-1195 |
Full Name | Southeastern Ct Primary Care, Llc |
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Speciality | Clinic/Center |
Location | 495 Gold Star Hwy Ste 112, Groton, Connecticut |
Authorized Official Name and Position | Rosalinda G Gaona (PHYSICIAN) |
Authorized Official Contact | 8606918084 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Southeastern Ct Primary Care, Llc 495 Gold Star Hwy Ste 112 Groton CT 06340-6229 Ph: (860) 691-8084 | Southeastern Ct Primary Care, Llc 495 Gold Star Hwy Ste 112 Groton CT 06340-6229 Ph: (860) 691-8084 |
NPI Number | 1134591696 |
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Provider Enumeration Date | 10/23/2015 |
Last Update Date | 01/16/2025 |
Medicare PECOS PAC ID | 5395047823 |
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Medicare Enrollment ID | O20151230000848 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134591696 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Rosalinda G Gaona |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1508879685 PECOS PAC ID: 0941295042 Enrollment ID: I20040419000112 |
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