| Ellen Buffa, Llc | |
|
112 Spencer St Manchester CT 06040-4601 | |
| (508) 341-2833 | |
| Not Available |
| Full Name | Ellen Buffa, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 112 Spencer St, Manchester, Connecticut |
| Authorized Official Name and Position | Ellen Buffa (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5083412833 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen Buffa, Llc 112 Spencer St Manchester CT 06040-4601 Ph: (508) 341-2833 | Ellen Buffa, Llc 112 Spencer St Manchester CT 06040-4601 Ph: (508) 341-2833 |
| NPI Number | 1033868872 |
|---|---|
| Provider Enumeration Date | 03/21/2022 |
| Last Update Date | 03/21/2022 |
| Certification Date | 03/21/2022 |
| Medicare PECOS PAC ID | 1951788934 |
|---|---|
| Medicare Enrollment ID | O20220512001266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033868872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ellen Ann Buffa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164069571 PECOS PAC ID: 2860879848 Enrollment ID: I20220512001487 |
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