| Southeastern Ct Primary Care, Llc | |
| 
					495 Gold Star Hwy Ste 112 Groton CT 06340-6229  | |
| (860) 691-8084 | |
| (860) 691-1195 | 
| Full Name | Southeastern Ct Primary Care, Llc | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 495 Gold Star Hwy Ste 112, Groton, Connecticut | 
| Authorized Official Name and Position | Rosalinda G Gaona (PHYSICIAN) | 
| Authorized Official Contact | 8606918084 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Southeastern Ct Primary Care, Llc 495 Gold Star Hwy Ste 112 Groton CT 06340-6229 Ph: (860) 691-8084  | Southeastern Ct Primary Care, Llc 495 Gold Star Hwy Ste 112 Groton CT 06340-6229 Ph: (860) 691-8084  | 
| NPI Number | 1134591696 | 
|---|---|
| Provider Enumeration Date | 10/23/2015 | 
| Last Update Date | 01/16/2025 | 
| Medicare PECOS PAC ID | 5395047823 | 
|---|---|
| Medicare Enrollment ID | O20151230000848 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1134591696 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary | 
| Provider Name | Rosalinda G Gaona | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1508879685 PECOS PAC ID: 0941295042 Enrollment ID: I20040419000112  | 
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