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General NPI Number Information
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NPI Number | 1487862801
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Entity Type | Organization
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Legal Business Name | PURANIK FAMILY MEDICAL CENTER LLC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 546 S BROAD ST UNIT 2E
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City | MERIDEN
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State | CT
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Zip | 06450-6600
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Country | US
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Telephone | 203-237-1054
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Fax | 203-237-9913
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Provider Business Mailing Address
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Address Line | 546 S BROAD ST STE 2E UNIT 2E
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City | MERIDEN
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State | CT
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Zip | 06450-6601
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Country | US
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Telephone | 203-237-1054
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Fax | 203-237-9913
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Authorized Official
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Title or Position | MEMBERLLC
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Name | DR. UJWALA P PURANIK
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Credential | M.D
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Telephone | 203-237-1054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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