| Medical Center Of Northeast Connecticut | |
|
612 Hartford Pike Dayville CT 06241-2159 | |
| (860) 779-0284 | |
| (860) 779-0386 |
| Full Name | Medical Center Of Northeast Connecticut |
|---|---|
| Speciality | Internal Medicine |
| Location | 612 Hartford Pike, Dayville, Connecticut |
| Authorized Official Name and Position | Paul J Matty (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8607790284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Center Of Northeast Connecticut 612 Hartford Pike Dayville CT 06241-2159 Ph: (860) 779-0284 | Medical Center Of Northeast Connecticut 612 Hartford Pike Dayville CT 06241-2159 Ph: (860) 779-0284 |
| NPI Number | 1194915314 |
|---|---|
| Provider Enumeration Date | 07/25/2007 |
| Last Update Date | 09/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194915314 | NPI | - | NPPES |
| 001172865 | Medicaid | CT | |
| 001367178 | Medicaid | CT | |
| 001292490 | Medicaid | CT | |
| 001413476 | Medicaid | CT | |
| 001228592 | Medicaid | CT | |
| 001295006 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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