Healthcare Provider Details

I. General information

NPI: 1194720391
Provider Name (Legal Business Name): DOCTORS OF AVON MEDICAL GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 W AVON RD LOWR LEVEL
AVON CT
06001-3678
US

IV. Provider business mailing address

30 W AVON RD LOWR LEVEL
AVON CT
06001-3678
US

V. Phone/Fax

Practice location:
  • Phone: 860-673-2581
  • Fax: 860-675-6202
Mailing address:
  • Phone: 860-673-2581
  • Fax: 860-675-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number015709
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number034848
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number036636
License Number StateCT

VIII. Authorized Official

Name: DR. SATESH CHANDRA SINGH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 860-673-2581