Healthcare Provider Details

I. General information

NPI: 1336582931
Provider Name (Legal Business Name): UROCARE PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2013
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 N MEADOW RD
WINDSOR CT
06095-2524
US

IV. Provider business mailing address

10 AUTUMN LEAVES RD
WALLINGFORD CT
06492-3358
US

V. Phone/Fax

Practice location:
  • Phone: 866-711-6046
  • Fax:
Mailing address:
  • Phone: 203-314-9493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSA A BRUNELLE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 203-314-9493