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Organization
HEALTHWISE MEDICAL ASSOCIATES, LLP
Active
Organization
HEALTHWISE MEDICAL ASSOCIATES, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE IRVIN (CEO)
(860) 872-2289
Entity
Organization
Contact information
Practice address
29 NAEK RD, SUITE 5, VERNON, CT 06066-3942
(860) 872-2289
(860) 896-1425
Mailing address
PO BOX 3249, VERNON, CT 06066-2149
(860) 896-1422
(860) 896-1425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
363LP0200X
Pediatric Nurse Practitioner
000765
CT
Other
Enumeration date
05/22/2006
Last updated
05/15/2014
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