Organization
URGENT CARE OF DERBY, LLC
Active
Other names
PhysicianOne Urgent Care- Derby
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNIE M KENKARE MD (CHIEF MEDICAL OFFICER)
(860) 657-8289
Entity
Organization
Contact information
Practice address
78 PERSHING DR, DERBY, CT 06418-1433
(203) 516-5307
Mailing address
2928 MAIN ST, GLASTONBURY, CT 06033-1007
(860) 657-8289
(860) 657-8291
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008049195
—
CT
05
—
008049245
—
CT
05
—
008049246
—
CT
05
—
008056635
—
CT
Enumeration date
03/09/2015
Last updated
03/09/2015
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