| Mentalwellnessmd | |
|
45 S Main St Ste 302 West Hartford CT 06107-2402 | |
| (860) 698-3600 | |
| Not Available |
| Full Name | Mentalwellnessmd |
|---|---|
| Speciality | Internal Medicine |
| Location | 45 S Main St Ste 302, West Hartford, Connecticut |
| Authorized Official Name and Position | Thomas Brown (SOLE MEMBER) |
| Authorized Official Contact | 8606983600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mentalwellnessmd 45 S Main St Ste 302 West Hartford CT 06107-2402 Ph: (860) 698-3600 | Mentalwellnessmd 45 S Main St Ste 302 West Hartford CT 06107-2402 Ph: (860) 698-3600 |
| NPI Number | 1609495134 |
|---|---|
| Provider Enumeration Date | 04/14/2020 |
| Last Update Date | 10/12/2021 |
| Medicare PECOS PAC ID | 5294131652 |
|---|---|
| Medicare Enrollment ID | O20210909002626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609495134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Thomas A Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053402263 PECOS PAC ID: 0941301774 Enrollment ID: I20070724000542 |
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