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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 Specialty Code Provider Type

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for GENESIS ELDERCARE PHYSICIAN SERVICES LLC

NPI Number 1164415196
LBN Legal business name GENESIS ELDERCARE PHYSICIAN SERVICES LLC
Authorized official ERIC SHAPIRO - (VP, AREA CONTROLLER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/24/2005
Last updated 08/05/2019 - About 7 years ago
Identifiers
CT Medicaid 004126919
CT Medicaid 004195021
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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