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General NPI Number Information
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NPI Number | 1659196947
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Entity Type | Organization
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Legal Business Name | FREEDOM PRIMARY CARE LLC
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 45 RUSSELL ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1312
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Country | US
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Telephone | 860-245-1791
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Fax | 860-969-2791
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Provider Business Mailing Address
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Address Line | 45 RUSSELL ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1312
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Country | US
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Telephone | 860-245-1791
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Fax |
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Authorized Official
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Title or Position | OWNER, CEO, NP
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Name | YVONNE L JOY
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Credential | APRN
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Telephone | 860-539-5262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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