Organization
MANCHESTER FAMILY CARE LLC
Active
Organization
MANCHESTER FAMILY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED A MEMON MD (PHYSICIAN)
(860) 648-4402
Entity
Organization
Contact information
Practice address
75 JOSEPH LN, SOUTH WINDSOR, CT 06074-1416
(860) 648-4402
Mailing address
75 JOSEPH LN, SOUTH WINDSOR, CT 06074-1416
(860) 648-4402
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
042588
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C03418
—
CT
Enumeration date
08/20/2006
Last updated
08/22/2020
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