Provider Demographics
NPI:1700075355
Name:HEALTH ONE PHYSICIAN ASSOCIATES PC
Entity Type:Organization
Organization Name:HEALTH ONE PHYSICIAN ASSOCIATES PC
Other - Org Name:HEALTH ONE WINDSOR FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-741-3069
Mailing Address - Street 1:113 ELM STREET
Mailing Address - Street 2:HEALTH ONE PHYSICIAN ASSOCIATES PC SUITE 302
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082
Mailing Address - Country:US
Mailing Address - Phone:860-741-3069
Mailing Address - Fax:860-745-3864
Practice Address - Street 1:851 MARSHALL PHELPS ROAD
Practice Address - Street 2:HEALTH ONE WINDSOR FAMILY MEDICINE
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095
Practice Address - Country:US
Practice Address - Phone:860-683-0756
Practice Address - Fax:860-683-1555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH ONE PHYSICIAN ASSOCIATES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-19
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty