Provider Demographics
NPI:1972786531
Name:PRIMARY CARE FOR WOMEN MARY CUMMINGS SATTI,M.D., LLC
Entity Type:Organization
Organization Name:PRIMARY CARE FOR WOMEN MARY CUMMINGS SATTI,M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINGS SATTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-434-8847
Mailing Address - Street 1:8 VISTA DR
Mailing Address - Street 2:EASTPORT NORTH BUSINESS PARK
Mailing Address - City:OLD LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06371-1587
Mailing Address - Country:US
Mailing Address - Phone:860-434-8847
Mailing Address - Fax:860-434-0428
Practice Address - Street 1:8 VISTA DR
Practice Address - Street 2:EASTPORT NORTH BUSINESS PARK
Practice Address - City:OLD LYME
Practice Address - State:CT
Practice Address - Zip Code:06371-1587
Practice Address - Country:US
Practice Address - Phone:860-434-8847
Practice Address - Fax:860-434-0428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033112207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02806Medicare PIN