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General NPI Number Information
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NPI Number | 1639155997
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Entity Type | Organization
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Legal Business Name | MED- EAST ASSOCIATES LLC
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 200 MERROW RD
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City | TOLLAND
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State | CT
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Zip | 06084-3416
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Country | US
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Telephone | 860-456-1252
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Fax | 860-456-2278
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Provider Business Mailing Address
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Address Line | 200 MERROW RD
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City | TOLLAND
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State | CT
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Zip | 06084-3416
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Country | US
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Telephone | 860-456-1252
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Fax | 860-456-2278
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MARIE A HAKMILLER
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Credential |
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Telephone | 860-456-1252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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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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