Healthcare Provider Details
I. General information
NPI: 1891458352
Provider Name (Legal Business Name): PREFERRED HEALTHCARE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/20/2021
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7 MAGAURAN DR STE 3
STAFFORD SPRINGS CT
06076-4040
US
IV. Provider business mailing address
7 MAGAURAN DR STE 3
STAFFORD SPRINGS CT
06076-4040
US
V. Phone/Fax
- Phone: 860-684-5438
- Fax:
- Phone: 413-455-6638
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DOMENICK
BIANCHI
Title or Position: OWNER
Credential: APRN
Phone: 860-684-5438