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General NPI Number Information
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NPI Number | 1750276655
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Entity Type | Organization
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Legal Business Name | MHS PRIMARY CARE INC
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 35 SAYBROOK RD UNIT 6
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City | ESSEX
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State | CT
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Zip | 06426-1490
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Country | US
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Telephone | 860-767-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 28 CRESCENT ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3654
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Country | US
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Telephone | 860-358-4870
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Fax |
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Authorized Official
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Title or Position | ENROLLMENT COORDINATOR
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Name | ANNE LESICZKA
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Credential |
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Telephone | 860-358-4811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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 #3
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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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Taxonomy #4
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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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