| Claim | |
|
76 Batterson Park Rd Ste 106 Farmington CT 06032-2571 | |
| (203) 910-7533 | |
| Not Available |
| Full Name | Claim |
|---|---|
| Speciality | Internal Medicine |
| Location | 76 Batterson Park Rd Ste 106, Farmington, Connecticut |
| Authorized Official Name and Position | Jonathan Brenes (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Contact | 2039107533 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Claim 76 Batterson Park Rd Ste 106 Farmington CT 06032-2571 | Claim 76 Batterson Park Rd Ste 106 Farmington CT 06032-2571 Ph: (203) 910-7533 |
| NPI Number | 1336758325 |
|---|---|
| Provider Enumeration Date | 07/27/2020 |
| Last Update Date | 07/27/2020 |
| Certification Date | 07/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336758325 | NPI | - | NPPES |
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