Organization
MYSTIC GERIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUNE FLIRI M.B.A., M.S.W. (MANAGER)
(860) 536-8882
Entity
Organization
Contact information
Practice address
3 HERON RD, MYSTIC, CT 06355-3253
(860) 536-5302
(860) 536-5302
Mailing address
3 HERON RD, MYSTIC, CT 06355-3253
(860) 536-5302
(860) 536-5302
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
07/18/2006
Last updated
07/20/2015
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