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WELLNESS LOCKER NPI 1922479369


NPI Information

NPI: 1922479369
Provider Name: WELLNESS LOCKER
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
19 S. WALNUT ST, STE D
WAUREGAN, CT
ZIP 06387
Phone: (860) 481-2950
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WELLNESS LOCKER is a family medicine in Wauregan, 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. WELLNESS LOCKER NPI is 1922479369. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

19 S. WALNUT ST, STE D
WAUREGAN, CT
ZIP 06387-700
Phone: (860) 481-2950
Fax: (860) 412-9138

The provider's authorized official is Olivia Locker .
The authorized official title is Md and has the following contact phone number (860) 564-2323.

The enumeration date for this NPI number is 10/12/2015 and was last updated on 10/3/2023.


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
1207Q00000XFamily Medicine53961CONNECTICUTYes

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
1008062229MEDICAIDCONNECTICUT

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

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