National Provider Identifier Database

AVON MEDICAL WELLNESS CENTER LLC
Cardiovascular Disease

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.


Contact Information

AVON MEDICAL WELLNESS CENTER LLC
540 HOPMEADOW ST
SIMSBURY, CT06070-2496
Phone: 860-272-4646
Fax: 860-272-4642
Website:
Specialty Taxonomy Code
* Cardiovascular Disease 207RC0000X
Medical 363AM0700X

* Indicates primary specialty

NPI Profile & details for AVON MEDICAL WELLNESS CENTER LLC

NPI Number 1134509615
Legal business name
LBN
AVON MEDICAL WELLNESS CENTER LLC
Authorized official OFER SAGIV - (PRESIDENT/OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/01/2015
Last updated 12/14/2016 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • CT License #: 001816
  • CT License #: 047333
  • CT Medicaid: PENDING
  • CT Other: 047333 STATE LICENSE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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