Healthcare Provider Details
I. General information
NPI: 1851644801
Provider Name (Legal Business Name): STARLING PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2012
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 RETREAT AVE SUITE 400
HARTFORD CT
06106-2528
US
IV. Provider business mailing address
2110 SILAS DEANE HWY
ROCKY HILL CT
06067-2313
US
V. Phone/Fax
- Phone: 860-860-2582
- Fax: 860-571-6805
- Phone: 860-258-3480
- Fax: 860-571-6800
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0000X |
| Taxonomy | Hematology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
D
LEBENGER
Title or Position: CEO
Credential:
Phone: 908-790-6567