BREAKAWAY HEALTH SERVICES LLC NPI 1528777505

NPI Information

  • NPI: 1528777505
  • Provider Name: BREAKAWAY HEALTH SERVICES LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 843 MAIN ST # 15
    MANCHESTER, CT
    ZIP 06040
  • Phone: (860) 648-3001

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NPI Details

BREAKAWAY HEALTH SERVICES LLC is a family medicine in Manchester, 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. BREAKAWAY HEALTH SERVICES LLC NPI is 1528777505. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

843 MAIN ST # 15
MANCHESTER, CT
ZIP 06040-020
Phone: (860) 648-3001
Fax: (860) 648-3003

The provider's authorized official is Tim Bombard .
The authorized official title is Owner and has the following contact phone number (860) 214-4513.

The enumeration date for this NPI number is 11/18/2022 and was last updated on 12/18/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

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: 11/21/2025

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