Healthcare Provider Details

I. General information

NPI: 1104126663
Provider Name (Legal Business Name): VELOCITY URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2010
Last Update Date: 05/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 CROMWELL AVE
ROCKY HILL CT
06067-1841
US

IV. Provider business mailing address

PO BOX 949
ROCKY HILL CT
06067-0949
US

V. Phone/Fax

Practice location:
  • Phone: 860-249-1570
  • Fax:
Mailing address:
  • Phone: 860-249-1570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEKSANDR GORENBEYN
Title or Position: PARTNER
Credential: M.D.
Phone: 860-249-1570