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Organization
POURKAVOOS MEDICAL CENTER, LLC
Active
Organization
POURKAVOOS MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHOSRO POURKAVOOS MD (OWNER)
(860) 676-0090
Entity
Organization
Contact information
Practice address
35 NOD RD, SUITE 205, AVON, CT 06001-3826
(860) 676-0090
(860) 676-0040
Mailing address
35 NOD RD, SUITE 205, AVON, CT 06001-3826
(860) 676-0090
(860) 676-0040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
039709
CT
Other
Enumeration date
12/09/2010
Last updated
12/09/2010
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