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Organization
UC OF MOHEGAN LAKE, LLC
Active
Organization
UC OF MOHEGAN LAKE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNIE M KENKARE MD (CMO)
(203) 885-0808
Entity
Organization
Contact information
Practice address
2928 MAIN ST, GLASTONBURY, CT 06033-1007
(860) 657-8289
(203) 905-6824
Mailing address
3085 E MAIN ST STE 12A, MOHEGAN LAKE, NY 10547-1542
(914) 358-9612
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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