Provider Demographics
NPI:1790421741
Name:IVX HEALTH OF CONNECTICUT PC
Entity Type:Organization
Organization Name:IVX HEALTH OF CONNECTICUT PC
Other - Org Name:IVX HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIBELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-610-3727
Mailing Address - Street 1:214 CENTERVIEW DR STE 250
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3248
Mailing Address - Country:US
Mailing Address - Phone:615-610-3646
Mailing Address - Fax:
Practice Address - Street 1:119 HEBRON AVE UNIT B
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4223
Practice Address - Country:US
Practice Address - Phone:860-996-8117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty