# MASONICARE HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427250885
- **Authorized official:** JON-PAUL VENOIT (PRESIDENT & CEO)
- **Authorized official phone:** (203) 679-5000

## Contact information

- **Practice address:** 22 MASONIC AVE, WALLINGFORD, CT 06492-3048
- **Practice address phone:** (203) 679-5900
- **Mailing address:** 22 MASONIC AVE, WALLINGFORD, CT 06492-3048
- **Mailing address phone:** (203) 679-5900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335E00000X | Prosthetic/Orthotic Supplier | 0075 | CT | Yes |

## Other

- **Enumeration date:** 06/05/2007
- **Last updated:** 11/05/2019