Organization
VERNON MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN COHUN (OFFICE MANAGER)
(860) 871-0385
Entity
Organization
Contact information
Practice address
385 W CENTER ST, MANCHESTER, CT 06040-4738
(860) 871-0385
Mailing address
385 W CENTER ST, MANCHESTER, CT 06040-4738
(860) 871-0385
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
014401
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C03080
MEDICARE GROUP
CT
Enumeration date
06/16/2006
Last updated
03/05/2008
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