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Organization

MHS PRIMARY CARE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANNE LESICZKA (CREDENTIALING COORDINATOR)
(860) 358-4811
Entity
Organization

Contact information

Practice address
1353 BOSTON POST RD, MADISON, CT 06443-3445
(203) 245-4933
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-4820
(860) 358-8661

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
363A00000X
Physician Assistant
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
11/07/2018
Last updated
11/09/2018
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