| Masonicare Primary Care Physicians | |
|
67 Masonic Avenue 1st Floor Wallingford CT 06492 | |
| (203) 265-0355 | |
| (203) 265-7413 |
| Full Name | Masonicare Primary Care Physicians |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 67 Masonic Avenue, Wallingford, Connecticut |
| Authorized Official Name and Position | Alla Bernshteyn (PRESIDENT) |
| Authorized Official Contact | 2032650355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Masonicare Primary Care Physicians 67 Masonic Avenue 1st Floor Wallingford CT 06492 Ph: (203) 265-0355 | Masonicare Primary Care Physicians 67 Masonic Avenue 1st Floor Wallingford CT 06492 Ph: (203) 265-0355 |
| NPI Number | 1922084540 |
|---|---|
| Provider Enumeration Date | 12/15/2005 |
| Last Update Date | 01/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922084540 | NPI | - | NPPES |
| 004178605 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
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