| Gericare | |
|
464 Wolcott Rd Wolcott CT 06716-2626 | |
| (203) 633-4560 | |
| Not Available |
| Full Name | Gericare |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 464 Wolcott Rd, Wolcott, Connecticut |
| Authorized Official Name and Position | Jonathan J Brenes (CEO) |
| Authorized Official Contact | 2039107533 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gericare 464 Wolcott Rd Wolcott CT 06716-2626 Ph: (203) 633-4560 | Gericare 464 Wolcott Rd Wolcott CT 06716-2626 Ph: (203) 633-4560 |
| NPI Number | 1366687790 |
|---|---|
| Provider Enumeration Date | 12/15/2008 |
| Last Update Date | 02/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366687790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 363A00000X | Physician Assistant | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Primary |
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