Provider Type Icon

PHYSICIAN SERVICES OF NORTHEAST NPI 1891962221


NPI Information

NPI: 1891962221
Provider Name: PHYSICIAN SERVICES OF NORTHEAST

Doing Business As: PHYSICIAN SERVICES OF NORTHEAST CONNECTICUT, LLC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
320 POMFRET ST
SUITE CSB2
PUTNAM, CT
ZIP 06260
Phone: (860) 928-6541
Get Directions

PHYSICIAN SERVICES OF NORTHEAST is a family medicine in Putnam, CT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PHYSICIAN SERVICES OF NORTHEAST NPI is 1891962221. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Physician Services Of Northeast Connecticut, Llc.

The provider's business location address is:

320 POMFRET ST
SUITE CSB2
PUTNAM, CT
ZIP 06260-836
Phone: (860) 928-6541
Fax: (860) 963-6450

The provider's authorized official is Julie Drouin .
The authorized official title is Cfo and has the following contact phone number (860) 928-6541.

The enumeration date for this NPI number is 5/14/2008 and was last updated on 9/16/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgeryNo
2207N00000XDermatologyNo
3176B00000XMidwifeCONNECTICUTNo
4207QA0000XFamily MedicineAdolescent MedicineNo
5207QA0505XFamily MedicineAdult MedicineNo
6207R00000XInternal MedicineNo
7207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1008001905MEDICAIDCONNECTICUT
2008014016MEDICAIDCONNECTICUT
3D100000012MEDICARE PINCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.