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Organization

MASONICARE HEALTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JON-PAUL VENOIT (PRESIDENT & CEO)
(203) 679-5000
Entity
Organization

Contact information

Practice address
22 MASONIC AVE, WALLINGFORD, CT 06492-3048
(203) 679-5900
Mailing address
22 MASONIC AVE, WALLINGFORD, CT 06492-3048
(203) 679-5900

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
0075
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004014791
CT
Enumeration date
06/05/2007
Last updated
11/05/2019
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