Healthcare Provider Details
I. General information
NPI: 1588264659
Provider Name (Legal Business Name): URGENT CARE CENTER OF BLOOMFIELD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/28/2020
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
699 COTTAGE GROVE RD
BLOOMFIELD CT
06002-3059
US
IV. Provider business mailing address
699 COTTAGE GROVE RD
BLOOMFIELD CT
06002-3059
US
V. Phone/Fax
- Phone: 860-242-0034
- Fax: 860-242-3301
- Phone: 860-242-0034
- Fax: 860-242-3301
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GILBERTO
E
RAMIREZ
Title or Position: OWNER
Credential: MD
Phone: 860-242-0034