# SILVER LANE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDICAL CARE CENTER OF EAST HARTFORD LLC
- **Other names:** Silver Lane Medical Center, SILVER LANE MEDICAL GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164456406
- **Legal business name:** MEDICAL CARE CENTER OF EAST HARTFORD LLC
- **Authorized official:** DR. SULTAN QURAISHI MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (860) 568-7243

## Contact information

- **Practice address:** 677 SILVER LN, EAST HARTFORD, CT 06118-1257
- **Practice address phone:** (860) 568-7243
- **Practice address fax:** (860) 895-8107
- **Mailing address:** 677 SILVER LN, EAST HARTFORD, CT 06118-1257
- **Mailing address phone:** (860) 568-7243
- **Mailing address fax:** (860) 895-8107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 08/25/2023