Healthcare Provider Details

I. General information

NPI: 1841526068
Provider Name (Legal Business Name): THE URGENT CARE CENTER OF CONNECTICUT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2009
Last Update Date: 01/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 COTTAGE GROVE RD SUITE B
BLOOMFIELD CT
06002-3119
US

IV. Provider business mailing address

421 COTTAGE GROVE RD SUITE B
BLOOMFIELD CT
06002-3119
US

V. Phone/Fax

Practice location:
  • Phone: 860-242-3933
  • Fax: 860-242-3301
Mailing address:
  • Phone: 860-242-3933
  • Fax: 860-242-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number018911
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number018911
License Number StateCT

VIII. Authorized Official

Name: GILBERTO RAMIREZ
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 860-242-0034