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General NPI Number Information
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NPI Number | 1609306539
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Entity Type | Organization
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Legal Business Name | KILLINGLY MEDICAL CENTER LLC
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 545 HARTFORD PIKE
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City | DAYVILLE
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State | CT
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Zip | 06241-2150
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Country | US
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Telephone | 860-204-0883
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Fax |
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Provider Business Mailing Address
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Address Line | 2 LATHROP AVE
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City | NORWICH
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State | CT
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Zip | 06360-2340
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | DR. YOGESH K KATECHIA
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Credential | MD
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Telephone | 860-204-0883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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