Organization
INNOVATIVE HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET M BERKLEY RN (MANAGING MEMBER)
(203) 687-9502
Entity
Organization
Contact information
Practice address
555 AMITY RD., WOODBRIDGE, CT 06525
(203) 687-9502
(203) 795-5645
Mailing address
325 BOSTON POST RD., #1E, ORANGE, CT 06477
(203) 687-9502
(203) 795-5645
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
302F00000X
CT
Other
Enumeration date
08/11/2010
Last updated
08/11/2010
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