Provider Demographics
NPI:1215398920
Name:VCARE FAMILY PRACTICE, LLC
Entity Type:Organization
Organization Name:VCARE FAMILY PRACTICE, LLC
Other - Org Name:SHIFA CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADVANCE PRACTICE REGISTERED NUR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:ALTAF
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, MBBS
Authorized Official - Phone:860-324-7988
Mailing Address - Street 1:145 UNION STREET
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-3025
Mailing Address - Country:US
Mailing Address - Phone:860-375-8440
Mailing Address - Fax:860-858-4091
Practice Address - Street 1:145 UNION STREET
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3025
Practice Address - Country:US
Practice Address - Phone:860-375-8440
Practice Address - Fax:860-858-4091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1300X
CT005393363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty