National Provider Identifier Database

GENESIS ELDERCARE PHYSICIAN SERVICES LLC
Geriatric Medicine

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.


Contact Information

GENESIS ELDERCARE PHYSICIAN SERVICES LLC
1 EMERSON DR
KIMBERLY HALL NORTH
WINDSOR, CT06095
Phone: 860-688-6443
Fax: 860-688-5230
Website:
Specialty Taxonomy Code
* Geriatric Medicine 207RG0300X
Internal Medicine 207R00000X

* Indicates primary specialty

NPI Profile & details for GENESIS ELDERCARE PHYSICIAN SERVICES LLC

NPI Number 1164415196
Legal business name
LBN
GENESIS ELDERCARE PHYSICIAN SERVICES LLC
Authorized official ERIC SHAPIRO - (VP, AREA CONTROLLER)
Entity Organization
Organization subpart No
Enumeration date 08/24/2005
Last updated 08/05/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • CT Medicaid: 004126919
  • CT Medicaid: 004195021

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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