Organization
CROSSROADS PRIMARY CARE, LLC
Active
Organization
CROSSROADS PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITHLESH GOVIL M.D. (OWNER / PHYSICIAN)
(860) 443-4455
Entity
Organization
Contact information
Practice address
196 PARKWAY S, SUITE 304, WATERFORD, CT 06385-1234
(860) 440-7525
(860) 447-8961
Mailing address
196 PARKWAY S, SUITE 304, WATERFORD, CT 06385-1234
(860) 442-7027
(860) 444-0074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
CT
332B00000X
Durable Medical Equipment & Medical Supplies
—
CT
363LA2200X
Adult Health Nurse Practitioner
—
CT
363LP2300X
Primary Care Nurse Practitioner
—
CT
Other
Enumeration date
08/28/2014
Last updated
04/01/2015
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