Healthcare Provider Details

I. General information

NPI: 1467937268
Provider Name (Legal Business Name): AFC PHYSICIANS OF CONNECTICUT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1171 E MAIN ST
TORRINGTON CT
06790-3963
US

IV. Provider business mailing address

1030 BOULEVARD
WEST HARTFORD CT
06119-1801
US

V. Phone/Fax

Practice location:
  • Phone: 860-866-4321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DONNA LOVALLO
Title or Position: DO
Credential:
Phone: 860-986-6440