| Andrew Ganeles Md Llc | |
|
381 Hopmeadow St Suite 101b Weatogue CT 06089-9692 | |
| (860) 651-1166 | |
| (860) 651-1167 |
| Full Name | Andrew Ganeles Md Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 381 Hopmeadow St, Weatogue, Connecticut |
| Authorized Official Name and Position | Andrew Ganeles (SOLE PRACTITIONER) |
| Authorized Official Contact | 8606511166 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew Ganeles Md Llc 381 Hopmeadow St Suite 101b Weatogue CT 06089-9692 Ph: (860) 651-1166 | Andrew Ganeles Md Llc 381 Hopmeadow St Suite 101b Weatogue CT 06089-9692 Ph: (860) 651-1166 |
| NPI Number | 1467727495 |
|---|---|
| Provider Enumeration Date | 03/08/2012 |
| Last Update Date | 03/08/2012 |
| Medicare PECOS PAC ID | 6507026879 |
|---|---|
| Medicare Enrollment ID | O20120323000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467727495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 035611 (Connecticut) | Primary |
| Provider Name | Andrew Ganeles |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902849755 PECOS PAC ID: 3375614100 Enrollment ID: I20080620000565 |
Ep Medical Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 85 Deer Park Rd, Weatogue, CT 06089 Phone: 718-362-1411 Fax: 718-362-1651 |