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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 Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for AVON MEDICAL WELLNESS CENTER LLC

NPI Number 1134509615
LBN Legal business name AVON MEDICAL WELLNESS CENTER LLC
Authorized official OFER SAGIV - (PRESIDENT/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/01/2015
Last updated 12/14/2016 - About 9 years ago
Identifiers
CT License # 001816
CT License # 047333
CT Medicaid PENDING
CT Other 047333 STATE LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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