| Renaissance Primary Care, Llc | |
|
11-15 Sandersdale Road Southbridge MA 01550 | |
| (774) 420-2311 | |
| (508) 519-0763 |
| Full Name | Renaissance Primary Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11-15 Sandersdale Road, Southbridge, Massachusetts |
| Authorized Official Name and Position | James Manuel (PSYCHOLOGIST) |
| Authorized Official Contact | 7744202311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaissance Primary Care, Llc 11-15 Sandersdale Road Southbridge MA 01550 Ph: (774) 420-2311 | Renaissance Primary Care, Llc 11-15 Sandersdale Road Southbridge MA 01550 Ph: (774) 420-2311 |
| NPI Number | 1649729021 |
|---|---|
| Provider Enumeration Date | 09/27/2016 |
| Last Update Date | 07/15/2025 |
| Certification Date | 07/15/2025 |
| Medicare PECOS PAC ID | 3476832379 |
|---|---|
| Medicare Enrollment ID | O20161117000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649729021 | NPI | - | NPPES |
| Provider Name | Adekunle G Fajana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396727806 PECOS PAC ID: 2365480498 Enrollment ID: I20050420000271 |
| Provider Name | Maria S Arrubla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881708394 PECOS PAC ID: 9335287671 Enrollment ID: I20091106000490 |
| Provider Name | James W Manuel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982849352 PECOS PAC ID: 8325171036 Enrollment ID: I20190822001258 |
| Provider Name | Sara B Gallant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194310862 PECOS PAC ID: 2062953037 Enrollment ID: I20240917004270 |
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