| Eastern Connecticut Physician Associates Llc | |
|
2701 Tamarack Ave South Windsor CT 06074-5562 | |
| (860) 375-5141 | |
| (860) 896-8190 |
| Full Name | Eastern Connecticut Physician Associates Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2701 Tamarack Ave, South Windsor, Connecticut |
| Authorized Official Name and Position | Gayethri Narayanswamy (PHYSICIAN) |
| Authorized Official Contact | 8603755141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Connecticut Physician Associates Llc 2701 Tamarack Ave South Windsor CT 06074-5562 Ph: (860) 375-5141 | Eastern Connecticut Physician Associates Llc 2701 Tamarack Ave South Windsor CT 06074-5562 Ph: (860) 375-5141 |
| NPI Number | 1821436007 |
|---|---|
| Provider Enumeration Date | 06/10/2013 |
| Last Update Date | 09/14/2021 |
| Certification Date | 09/14/2021 |
| Medicare PECOS PAC ID | 5799919494 |
|---|---|
| Medicare Enrollment ID | O20140221000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821436007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gayethri Narayanswamy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376670646 PECOS PAC ID: 9638223654 Enrollment ID: I20090811000268 |
| Provider Name | Leonardo Marquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689373839 PECOS PAC ID: 8022472083 Enrollment ID: I20230911001706 |
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