Organization
POUNDS, MEDICAL WEIGHT LOSS TRANSFORMATION, PC
Active
Organization
POUNDS, MEDICAL WEIGHT LOSS TRANSFORMATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE LYNN CAVO PA-C (PRESIDENT)
(860) 906-1289
Entity
Organization
Contact information
Practice address
125 LASALLE RD, SUITE 208, WEST HARTFORD, CT 06107-2322
(860) 906-1289
(860) 906-1269
Mailing address
125 LASALLE RD, SUITE 208, WEST HARTFORD, CT 06107-2322
(860) 906-1289
(860) 906-1269
Taxonomy
Speciality
Code
Description
License number
State
207VB0002X
Obesity Medicine (Obstetrics & Gynecology) Physician
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D100101600
MEDICARE PTAN
CT
Enumeration date
07/08/2014
Last updated
07/08/2014
Update your record
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