| Gastroenterology Health Associates | |
|
945 Main St Ste 202 Manchester CT 06040-6064 | |
| (860) 871-6710 | |
| Not Available |
| Full Name | Gastroenterology Health Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 945 Main St Ste 202, Manchester, Connecticut |
| Authorized Official Name and Position | Marc Dallaire (CREDENTIALING MANAGER) |
| Authorized Official Contact | 4013238755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Health Associates 773 Main St Manchester CT 06040-5102 Ph: (608) 716-7108 | Gastroenterology Health Associates 945 Main St Ste 202 Manchester CT 06040-6064 Ph: (860) 871-6710 |
| NPI Number | 1922708015 |
|---|---|
| Provider Enumeration Date | 03/07/2023 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 5294190245 |
|---|---|
| Medicare Enrollment ID | O20230427000887 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922708015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Alexia Thomas Koudellou |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346278066 PECOS PAC ID: 6204822802 Enrollment ID: I20070123000309 |
| Provider Name | Candice T Pych |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871563098 PECOS PAC ID: 8426244344 Enrollment ID: I20101118000026 |
| Provider Name | Andrea Dufour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679021273 PECOS PAC ID: 2062791007 Enrollment ID: I20161116000693 |
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