| Organization Name: | BACKUS HEALTH CENTERS |
| NPI Number: | 1033489984 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CINDY HABEEB (CREDENTIALS COORDINATOR) |
| Mailing Address: | 163 Broadway St Colchester |
| State: | CT US |
| Postal Code: | 064151022 |
| Phone Number: | 8605374601 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2012 |
| NPI Last Update Date: | 01/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 4880 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |