Provider Demographics
NPI:1639881956
Name:HHC ONE MEDICAL, LLC
Entity Type:Organization
Organization Name:HHC ONE MEDICAL, LLC
Other - Org Name:HHC ONE MEDICAL, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:VYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-972-7858
Mailing Address - Street 1:1290 SILAS DEANE HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:860-972-7145
Mailing Address - Fax:
Practice Address - Street 1:104 HEIGHTS RD STE R103
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4119
Practice Address - Country:US
Practice Address - Phone:888-663-6331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty