Organization Name: | VCARE FAMILY PRACTICE LLC |
NPI Number: | 1215398920 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MOHAMED HUSSAIN (CEO) |
Mailing Address: | 4 West Rd Ellington |
State: | CT US |
Postal Code: | 060294247 |
Phone Number: | 8603247988 |
Fax Number: | 8887094822 |
NPI Enumeration Date: | 03/09/2016 |
NPI Last Update Date: | 03/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 005393 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |