| Southern Connecticut Geriatric & Preventive Medicine Llc | |
|
390 Livingston St New Haven CT 06511-1336 | |
| (203) 871-9224 | |
| Not Available |
| Full Name | Southern Connecticut Geriatric & Preventive Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 390 Livingston St, New Haven, Connecticut |
| Authorized Official Name and Position | Asefeh Heiat (MEMBER) |
| Authorized Official Contact | 2038719224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Connecticut Geriatric & Preventive Medicine Llc 390 Livingston St New Haven CT 06511-1336 Ph: (203) 871-9224 | Southern Connecticut Geriatric & Preventive Medicine Llc 390 Livingston St New Haven CT 06511-1336 Ph: (203) 871-9224 |
| NPI Number | 1679701882 |
|---|---|
| Provider Enumeration Date | 06/25/2009 |
| Last Update Date | 10/04/2021 |
| Medicare PECOS PAC ID | 2365597911 |
|---|---|
| Medicare Enrollment ID | O20090922000146 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679701882 | NPI | - | NPPES |
| Provider Name | Asefeh Heiat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033119813 PECOS PAC ID: 2961491501 Enrollment ID: I20040510000644 |
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