Organization
MASONICARE PRIMARY CARE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLA BERNSHTEYN MD (PRESIDENT)
(203) 265-0355
Entity
Organization
Contact information
Practice address
67 MASONIC AVENUE, 1ST FLOOR, WALLINGFORD, CT 06492
(203) 265-0355
(203) 265-7413
Mailing address
67 MASONIC AVENUE, 1ST FLOOR, WALLINGFORD, CT 06492
(203) 265-0355
(203) 265-7413
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004178605
—
CT
Enumeration date
12/15/2005
Last updated
01/02/2008
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