| Ivx Health | |
|
119 Hebron Ave Unit B Glastonbury CT 06033-4223 | |
| (860) 996-8117 | |
| Not Available |
| Full Name | Ivx Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 119 Hebron Ave Unit B, Glastonbury, Connecticut |
| Authorized Official Name and Position | William Seibels (CFO) |
| Authorized Official Contact | 6156103727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivx Health 214 Centerview Dr Ste 250 Brentwood TN 37027-3248 Ph: (615) 610-3646 | Ivx Health 119 Hebron Ave Unit B Glastonbury CT 06033-4223 Ph: (860) 996-8117 |
| NPI Number | 1790421741 |
|---|---|
| Provider Enumeration Date | 05/11/2022 |
| Last Update Date | 10/11/2023 |
| Medicare PECOS PAC ID | 1658753967 |
|---|---|
| Medicare Enrollment ID | O20220803002220 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790421741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Stephanie Fow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679095129 PECOS PAC ID: 9739454687 Enrollment ID: I20171003007696 |
| Provider Name | Stephen Andrew Lasher |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1538188826 PECOS PAC ID: 9638183585 Enrollment ID: I20220823002145 |
| Provider Name | Danielle Cristina Boyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801392048 PECOS PAC ID: 2163787102 Enrollment ID: I20220901002343 |
| Provider Name | Samantha Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427832419 PECOS PAC ID: 9032563473 Enrollment ID: I20231003003905 |
| Provider Name | Paige Olmsted |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659150233 PECOS PAC ID: 6507218435 Enrollment ID: I20240117000305 |
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