Provider Demographics
NPI:1093292310
Name:PHYSICIANS ALLIANCE OF CONNECTICUT, LLC
Entity Type:Organization
Organization Name:PHYSICIANS ALLIANCE OF CONNECTICUT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARCHAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-488-7228
Mailing Address - Street 1:322 E MAIN ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3136
Mailing Address - Country:US
Mailing Address - Phone:203-488-7228
Mailing Address - Fax:203-488-7227
Practice Address - Street 1:350 GOOSE LN STE 203B
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2158
Practice Address - Country:US
Practice Address - Phone:203-408-2700
Practice Address - Fax:203-884-8201
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICIANS ALLIANCE OF CONNECTICUT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-20
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty