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GERIATRIC MEDICINE CONSULTANTS HOME VISIT PRACTICE, LLC

Physicians Internal Medicine Geriatric Medicine

Provider NPI: 1184896151

Organization Information:
Organization Name:  GERIATRIC MEDICINE CONSULTANTS HOME VISIT PRACTICE, LLC
Organization is not Subpart
Authorized Official:  ALISON  GROVER  MEMBER  860-232-9741

Practice Location:
33 BIRCH RD  WEST HARTFORD, CT 06119-1009 US
Tel: 860-232-9741  Fax: --

Business Mailing Address:
33 BIRCH RD  WEST HARTFORD, CT 06119-1009 US
Tel: 860-232-9741  Fax: --

NPI Information:
NPI: 1184896151
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207RG0300XPhysicians
Internal Medicine
Geriatric Medicine
CT031718

Other Provider Identifiers:

IssuerNumberStateType
001317181CT05
INDIVIDUAL NPI1326174574CT01
GROUP NPI1184896151CT01



American Medical Association 2012 taxonomy code information

Code: 207RG0300X

Type:

Classification:



Definition:



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