Organization Name: | ENFIELD AMBULATORY CARE CENTER LLC |
NPI Number: | 1922183268 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALFREDO ARBULU (MEMBER OWNER) |
Mailing Address: | 15 Palomba Drive Enfield |
State: | CT US |
Postal Code: | 06082 |
Phone Number: | 8607451684 |
Fax Number: | 8607415228 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0039 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |