Organization
4 ELEMENTS DIRECT PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VASANTH KAINKARYAM MD (MANAGING MEMBER)
(860) 469-5656
Entity
Organization
Contact information
Practice address
1300 SULLIVAN AVE, SOUTH WINDSOR, CT 06074-2713
(860) 469-5646
(860) 310-1122
Mailing address
1300 SULLIVAN AVE, SOUTH WINDSOR, CT 06074-2713
(860) 469-5646
(860) 310-1122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
—
—
Other
Enumeration date
06/08/2021
Last updated
11/01/2025
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