NPI 1629383906

Innovative Healthcare

Organisation Exclusive Provider Organization Woodbridge, CT

Practice location

Address: 555 Amity Rd., Woodbridge, CT 06525
Phone: (203) 687-9502
Fax: (203) 795-5645
Mailing address: 325 Boston Post Rd. #1e, Orange, CT 06477

Authorised official

Name: Janet M Berkley
Title: Managing Member
Phone: (203) 687-9502

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 302F00000X (CT)

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Registry record

NPI: 1629383906
Entity type: Organization
NPI issued: 11 Aug 2010
Record last updated: 11 Aug 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.