MEDICARE: AIMEE EGGLESTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	2835	CT

General Provider Information

NPI Number	:	1952051161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMEE EGGLESTON

Provider Business Mailing Address
First Line	:	483 CENTER RD
Second Line	:
City	:	WOODSTOCK
State	:	CT
Zip	:	06281-1707
Country	:	US
Telephone Number	:	860-942-3365
Fax Number	:

Provider Business Practice Location Address
First Line	:	483 CENTER RD
Second Line	:
City	:	WOODSTOCK
State	:	CT
Zip	:	06281-1707
Country	:	US
Telephone Number	:	860-942-3365
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	03/29/2022

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Directions to “ AIMEE EGGLESTON ” Practice Location

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