| Integrated Wound Care Connecticut Pllc | |
|
930 Mill Hill Ter Southport CT 06890-1265 | |
| (718) 705-6010 | |
| Not Available |
| Full Name | Integrated Wound Care Connecticut Pllc |
|---|---|
| Speciality | General Practice |
| Location | 930 Mill Hill Ter, Southport, Connecticut |
| Authorized Official Name and Position | Michael M Ginsburg (PRESIDENT) |
| Authorized Official Contact | 7189633495 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Wound Care Connecticut Pllc 492c Cedar Ln Ste 514 Teaneck NJ 07666-1713 Ph: () - | Integrated Wound Care Connecticut Pllc 930 Mill Hill Ter Southport CT 06890-1265 Ph: (718) 705-6010 |
| NPI Number | 1649778762 |
|---|---|
| Provider Enumeration Date | 01/23/2018 |
| Last Update Date | 03/15/2018 |
| Medicare PECOS PAC ID | 0042572893 |
|---|---|
| Medicare Enrollment ID | O20180315000678 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649778762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | George Edward Northrop |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760497432 PECOS PAC ID: 0345260485 Enrollment ID: I20051202000782 |
| Provider Name | Raheel Shafi |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1477759397 PECOS PAC ID: 3870646359 Enrollment ID: I20090730000550 |
| Provider Name | Scott Herman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396770145 PECOS PAC ID: 9739220781 Enrollment ID: I20100113000027 |
| Provider Name | Nicholas Verdura |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760645618 PECOS PAC ID: 1951425883 Enrollment ID: I20110826000199 |
| Provider Name | Karen Terwilliger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245616705 PECOS PAC ID: 0446569719 Enrollment ID: I20151028000314 |
| Provider Name | Diane Lusas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730475658 PECOS PAC ID: 9032430640 Enrollment ID: I20160519001057 |
| Provider Name | Alla Kirzon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952841199 PECOS PAC ID: 7012292865 Enrollment ID: I20170320000204 |
| Provider Name | Carrie M Reynolds |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1336571843 PECOS PAC ID: 8325282551 Enrollment ID: I20191121001860 |
| Provider Name | Krystl G Ortiz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1750649810 PECOS PAC ID: 4284030990 Enrollment ID: I20210903002000 |
Progressive Care Medical Group Of Ct, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 917 Mill Hill Ter, Southport, CT 06890 Phone: 203-204-3012 |