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General NPI Number Information
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NPI Number | 1770392003
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Entity Type | Organization
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Legal Business Name | DOCS URGENT AND PRIMARY CARE
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Dates
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Enumeration Date | 01/01/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 279 CHASE AVE
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City | WATERBURY
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State | CT
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Zip | 06704-2236
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Country | US
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Telephone | 203-528-4993
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Fax |
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Provider Business Mailing Address
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Address Line | 283 MOUNT FAIR DR
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City | WATERTOWN
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State | CT
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Zip | 06795-1657
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Country | US
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Telephone | 203-224-9376
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | BEATRICE VINCENT
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Credential | FNP-BC
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Telephone | 203-528-4993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | 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 | 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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