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Organization

WATERTOWN MEDICAL ASSOCIATES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAXIMILIAN GOMEZ-TROCHEZ MD (OWNER)
(860) 274-2418
Entity
Organization

Contact information

Practice address
170 MAIN ST, SOUTHINGTON, CT 06489-2506
(203) 558-5896
Mailing address
365 MAIN ST STE 201, WATERTOWN, CT 06795-2249
(860) 274-2418
(860) 274-2986

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
049979
CONNECTICARE
CT
01
05856125
GREAT WEST
CT
01
1154493
USA
CT
01
5856125
CIGNA
CT
01
P01040202
RAILROAD MEDICARE
CT
01
P4376817
OXFORD
CT
Enumeration date
01/09/2019
Last updated
05/07/2026
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