| The Healing Practice, Llc | |
|
555 Bridgeport Ave Shelton CT 06484-4749 | |
| (203) 550-2755 | |
| (877) 635-5324 |
| Full Name | The Healing Practice, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 555 Bridgeport Ave, Shelton, Connecticut |
| Authorized Official Name and Position | Andrew Killen (PRESIDENT) |
| Authorized Official Contact | 2035502755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Healing Practice, Llc 555 Bridgeport Ave Shelton CT 06484-4749 Ph: (203) 550-2755 | The Healing Practice, Llc 555 Bridgeport Ave Shelton CT 06484-4749 Ph: (203) 550-2755 |
| NPI Number | 1750742144 |
|---|---|
| Provider Enumeration Date | 03/11/2016 |
| Last Update Date | 03/11/2016 |
| Medicare PECOS PAC ID | 4385941376 |
|---|---|
| Medicare Enrollment ID | O20160317001841 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750742144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 046395 (Connecticut) | Primary |
| Provider Name | Andrew B Killen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528231552 PECOS PAC ID: 1658439070 Enrollment ID: I20081029000024 |
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