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General NPI Number Information
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NPI Number | 1386555233
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Entity Type | Organization
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Legal Business Name | HOME RHEUM LLC
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 1443 ALBANY AVE
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City | HARTFORD
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State | CT
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Zip | 06112-2110
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Country | US
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Telephone | 860-655-0443
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Fax |
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Provider Business Mailing Address
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Address Line | 32 FAIRFIELD LN
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City | BLOOMFIELD
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State | CT
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Zip | 06002-1994
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Country | US
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Telephone | 860-655-0443
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PAULINE PATRICIA WILKS
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Credential | FNP-BC
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Telephone | 860-655-0443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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