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NPI Code Detail

MEDICARE: WINDSOR MEDICAL ASSOCIATES LLC

MEDICARE: WINDSOR MEDICAL ASSOCIATES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1447222559
Entity Type Code : Organization
Provider Name (Legal Business Name) : WINDSOR MEDICAL ASSOCIATES LLC
Provider Business Mailing Address
First Line : 74 MACK ST
Second Line :
City : WINDSOR
State : CT
Zip : 06095-2759
Country : US
Telephone Number : 860-298-8830
Fax Number : 860-298-9929
Provider Business Practice Location Address
First Line : 74 MACK ST
Second Line :
City : WINDSOR
State : CT
Zip : 06095-2759
Country : US
Telephone Number : 860-298-8830
Fax Number : 860-298-9929
Authorized Official
Title or Position : PRESIDENT
Name : IAN D KLEINHEN
Credential : M.D.
Telephone Number : 860-298-8830
Provider Enumeration Date : 02/02/2006
Last Update Date : 10/24/2007

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Directions to “WINDSOR MEDICAL ASSOCIATES LLC ” Practice Location

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