Suhradam Medical Practice, Llc | |
50 Toll Gate Rd Berlin CT 06037-3606 | |
(860) 438-6004 | |
(860) 740-7103 |
Full Name | Suhradam Medical Practice, Llc |
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Speciality | Clinic/Center |
Location | 50 Toll Gate Rd, Berlin, Connecticut |
Authorized Official Name and Position | Brimal Babubhai Patel (CEO) |
Authorized Official Contact | 8604386004 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Suhradam Medical Practice, Llc 50 Toll Gate Rd Berlin CT 06037-3606 Ph: (860) 438-6004 | Suhradam Medical Practice, Llc 50 Toll Gate Rd Berlin CT 06037-3606 Ph: (860) 438-6004 |
NPI Number | 1932560281 |
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Provider Enumeration Date | 03/15/2016 |
Last Update Date | 03/15/2016 |
Medicare PECOS PAC ID | 7618260498 |
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Medicare Enrollment ID | O20160802000220 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932560281 | NPI | - | NPPES |
1083879522 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | 049253 (Connecticut) | Primary |
Provider Name | Brimal B Patel |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083879522 PECOS PAC ID: 8426230467 Enrollment ID: I20110311000168 |
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