Pomfret Street Family Medicine

LBN: Physician Services Of Northeast Connecticut, Llc
Pomfret Street Family Medicine is an health care organization with primary practice located at 235 Pomfret St , Putnam CT 06260-1835. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Physician Services Of Northeast Connecticut, Llc can be contacted via phone (860) 928-0493, or through Smanik, Robert E via phone (860) 928-6541.

Contact Information

Primary practice address
235 Pomfret St Putnam CT 06260-1835
Phone: (860) 928-0493
Fax: (860) 928-9255
Website:
Map and Directions
Authorized official contact:
Name: Smanik, Robert E
Phone: (860) 928-6541

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1194966556
LBN Legal business name Physician Services Of Northeast Connecticut, Llc
DBA Doing business as Pomfret Street Family Medicine
Authorized official Smanik, Robert E
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 16th, 2009
Last updated Mar 16th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194966556 NPPES
Connecticut MEDICAID 1891962221

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