| Prime Healthcare Ltc Pc | |
|
30 Jordan Ln Wethersfield CT 06109-1278 | |
| (860) 263-0263 | |
| (860) 263-0267 |
| Full Name | Prime Healthcare Ltc Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 30 Jordan Ln, Wethersfield, Connecticut |
| Authorized Official Name and Position | Wayne Paulekas (MD/OWNER) |
| Authorized Official Contact | 8602630263 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Healthcare Ltc Pc 30 Jordan Ln Wethersfield CT 06109-1278 Ph: (860) 263-0263 | Prime Healthcare Ltc Pc 30 Jordan Ln Wethersfield CT 06109-1278 Ph: (860) 263-0263 |
| NPI Number | 1326886359 |
|---|---|
| Provider Enumeration Date | 07/15/2024 |
| Last Update Date | 07/15/2024 |
| Medicare PECOS PAC ID | 3779021506 |
|---|---|
| Medicare Enrollment ID | O20240812003150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326886359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Wayne C Paulekas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730166422 PECOS PAC ID: 7416859582 Enrollment ID: I20091230000598 |
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