Stafford Medical Group Llc | |
146 Main St Somers CT 06071-1825 | |
(860) 749-8018 | |
(860) 316-4015 |
Full Name | Stafford Medical Group Llc |
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Speciality | Family Medicine |
Location | 146 Main St, Somers, Connecticut |
Authorized Official Name and Position | Sultan Alam Quraishi (MEDICAL DIRECTOR) |
Authorized Official Contact | 8605583624 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Stafford Medical Group Llc 146 Main St Somers CT 06071-1825 Ph: (860) 749-8018 | Stafford Medical Group Llc 146 Main St Somers CT 06071-1825 Ph: (860) 749-8018 |
NPI Number | 1518098698 |
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Provider Enumeration Date | 03/08/2007 |
Last Update Date | 01/29/2015 |
Medicare PECOS PAC ID | 0941100291 |
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Medicare Enrollment ID | O20040112000217 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518098698 | NPI | - | NPPES |
130076400 | Other | CT | BLUE CARE FAMILY PLAN |
010030076CT04 | Other | CT | ANTHEM |
4245029 | Other | CT | AETNA |
5861484 | Other | CT | CIGNA |
HAS028 | Other | CT | OXFORD |
00000898346 | Other | CT | UNITED HEALTHCARE |
2V4565 | Other | CT | HEALTHNET |
217079 | Medicaid | CT | |
781160 | Other | CT | CONNECTICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 30076 (Connecticut) | Primary |
208600000X | Surgery | 30076 (Connecticut) | Secondary |
363L00000X | Nurse Practitioner | 5393 (Connecticut) | Secondary |
Provider Name | Misbah M Vahidy |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1164461091 PECOS PAC ID: 8628962602 Enrollment ID: I20040211000068 |
Provider Name | Sultan A Quraishi |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1144200122 PECOS PAC ID: 7214837590 Enrollment ID: I20081212000554 |
Provider Name | Srinivasulu Conjeevaram |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780958058 PECOS PAC ID: 6103054655 Enrollment ID: I20150709000399 |
Provider Name | Vrunda J Shah |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891242004 PECOS PAC ID: 5193007623 Enrollment ID: I20170118001763 |
Provider Name | Suzanne Viger |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760957526 PECOS PAC ID: 8628322278 Enrollment ID: I20181116001661 |
Provider Name | Jennifer Anne Briggs |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255878773 PECOS PAC ID: 8022169226 Enrollment ID: I20181205000135 |
Somers Family Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Battle Street, Suite 1a, Somers, CT 06071 Phone: 860-749-8887 Fax: 860-749-7421 |