| West Hartford Medical Center | |
|
74 Park Rd Ste 4 West Hartford CT 06119-1898 | |
| (860) 218-1725 | |
| Not Available |
| Full Name | West Hartford Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 74 Park Rd Ste 4, West Hartford, Connecticut |
| Authorized Official Name and Position | Angel C. Jaquez (DIRECTOR) |
| Authorized Official Contact | 8602181725 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Hartford Medical Center 74 Park Rd Ste 4 West Hartford CT 06119-1898 Ph: (860) 218-1725 | West Hartford Medical Center 74 Park Rd Ste 4 West Hartford CT 06119-1898 Ph: (860) 218-1725 |
| NPI Number | 1942533039 |
|---|---|
| Provider Enumeration Date | 09/08/2009 |
| Last Update Date | 12/18/2012 |
| Medicare PECOS PAC ID | 4284764598 |
|---|---|
| Medicare Enrollment ID | O20100614000298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942533039 | NPI | - | NPPES |
| 008022952 | Medicaid | CT | |
| 6464646 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Secondary |
| Provider Name | Corey A Jaquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205073962 PECOS PAC ID: 8628105210 Enrollment ID: I20100430000472 |
| Provider Name | Igor V Samegulin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255517249 PECOS PAC ID: 7416136668 Enrollment ID: I20110120000612 |
Judith M. Mascolo, Md, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 639 Park Rd, Ste 100, West Hartford, CT 06107 Phone: 860-233-4600 Fax: 860-233-4604 | |
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Afc Physicians Of Connecticut, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1030 Boulevard, West Hartford, CT 06119 Phone: 860-986-6440 Fax: 203-826-2139 | |
Real Life Medical Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1245 Farmington Ave # 226, West Hartford, CT 06107 Phone: 860-470-6630 Fax: 862-298-0763 | |
Visavis Health Care Medical Group Of Ct Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Emily Way, West Hartford, CT 06107 Phone: 718-534-0689 | |
Quinones Medical Group Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1007 Farmington Ave, Suite 3a, West Hartford, CT 06107 Phone: 860-570-4882 Fax: 860-570-4885 | |
Luca Health & Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2475 Albany Ave Ste 205, West Hartford, CT 06117 Phone: 203-623-6487 |