Organization
BACKUS HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY HABEEB (CREDENTIALS COORDINATOR)
(860) 425-8715
Entity
Organization
Contact information
Practice address
163 BROADWAY ST, COLCHESTER, CT 06415-1022
(860) 537-4601
Mailing address
112 LAFAYETTE ST, NORWICH, CT 06360-2737
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4880
CT
Other
Enumeration date
01/10/2012
Last updated
01/10/2012
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