| East Hartford Family Practice Llp | |
|
110 Main St 1st Fl East Hartford CT 06118-3208 | |
| (860) 569-4430 | |
| (860) 569-4431 |
| Full Name | East Hartford Family Practice Llp |
|---|---|
| Speciality | Family Medicine |
| Location | 110 Main St, East Hartford, Connecticut |
| Authorized Official Name and Position | Joseph Michael Danyliw (OWNER) |
| Authorized Official Contact | 8605694430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Hartford Family Practice Llp 110 Main St 1st Fl East Hartford CT 06118-3208 Ph: (860) 569-4430 | East Hartford Family Practice Llp 110 Main St 1st Fl East Hartford CT 06118-3208 Ph: (860) 569-4430 |
| NPI Number | 1659552768 |
|---|---|
| Provider Enumeration Date | 11/16/2007 |
| Last Update Date | 11/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659552768 | NPI | - | NPPES |
| 1058742 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 005874 (Connecticut) | Primary |
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