AVON MEDICAL WELLNESS CENTER LLC (NPI# 1134509615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134509615 |
| Entity Type | Organization |
| Organization Name | AVON MEDICAL WELLNESS CENTER LLC |
| Practice Address |
540 Hopmeadow St Simsbury CT 06070-2496 |
| Practice Telephone | 8602724646 |
| Practice Fax Number | 8602724642 |
| Mailing Telephone | 8602724646 |
| Mailing Fax Number | 8602724642 |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2016-12-14 |
| Authorized Official Name | DR. OFER SAGIV (PRESIDENT/OWNER) |
| Authorized Official Telephone | 8602724646 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
001816 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
047333 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | STATE LICENSE | 047333 | 01 |
| CT | PENDING | 05 |
| Street Address |
540 HOPMEADOW ST |
| City | SIMSBURY |
| State | CT |
| Zip Code | 06070-2496 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427016849 | Gerard Charles Buffo | Radiology | 540 Hopmeadow St, Simsbury, CT 06070 | 2006-05-03 |
| 1972130490 | Karen Elizabeth Rowan | Massage Therapist | 540 Hopmeadow St, Simsbury, CT 06070-2496 | 2020-03-25 |
| 1902230766 | Women Reshaping Lives, LLC | Community/Behavioral Health | 540 Hopmeadow St, Simsbury, CT 06070-2496 | 2013-08-29 |
| 1720300015 | Louisa Theresa Krause | Marriage & Family Therapist | 540 Hopmeadow St, Simsbury, CT 06070-2496 | 2010-02-27 |
| 1689810491 | Ofer Sagiv | Internal Medicine | 540 Hopmeadow St, Cardiology, Simsbury, CT 06070-2496 | 2008-12-29 |
| 1932396587 | Jayne Wilson Blanchette | Social Worker | 540 Hopmeadow St, Simsbury, CT 06070-2496 | 2007-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225450620 | Nataly Edmee Lapin | Counselor | 1243 Hopmeadow St Ste D, Simsbury, CT 06070 | 2014-01-20 |
| 1689950545 | Mary Beth Walsh | Pharmacist | 540 Bushy Hill Road, Simsbury, CT 06070 | 2011-10-24 |
| 1437335700 | Lisa Hope Cooperman | Dietitian, Registered | 8 Wilcox St, Simsbury, CT 06070 | 2008-01-16 |
| 1790974657 | State of Connecticut | Durable Medical Equipment & Medical Supplies | 381 Hopmeadow Street, Simsbury, CT 06070 | 2007-10-17 |
| 1104025378 | Michelle-lisa Weller Voegtle | Counselor | 2 Westridge Drive, Simsbury, CT 06070 | 2007-07-17 |
| 1285851287 | Richard Connolly-walker | Chiropractor | 530 Bushy Hill Road, Suite 200, Simsbury, CT 06070 | 2007-04-19 |
| 1801012943 | Eastern Rehabilitation Network | Physical Therapist | 200 Hopmeadow Street, Eastern Rehabilitation Network, Simsbury, CT 06070 | 2007-04-17 |
| 1104049956 | Philip Emil Pilon | Dentist | 625 Hopmeadow Street, Simsbury, CT 06070 | 2007-04-10 |
| 1215054929 | Valley Psychiatry LLC | Nurse Practitioner | 542 Hopmeadow St, Simsbury, CT 06070 | 2007-03-26 |
| 1225162522 | Anthony J Zukowski | Physical Therapist | 923 Hopmeadow Street, Simsbury, CT 06070 | 2007-03-16 |
| Find all providers in zip 06070 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053303503 | Michael J Rinaldi | Internal Medicine | 32 Pinnacle Mountain Road, Simsbury, CT 06070-1809 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922527050 | Lindacare Inc. | Internal Medicine | 20 Church St Ste 1780, Hartford, CT 06103-1246 | 2017-09-09 |
| 1740678135 | Post-acute Cardiology Care LLC | Internal Medicine | 30 Old Kings Hwy S Ste 160, Darien, CT 06820-4519 | 2015-01-07 |
| 1144630328 | Allison Padegimas | Internal Medicine | 1062 Barnes Rd Ste 300, Wallingford, CT 06492-2576 | 2014-04-28 |
| 1871913244 | Jason Michael Goodman | Internal Medicine | 111 Osborne St Fl 3, Danbury, CT 06810-6000 | 2014-04-23 |
| 1669899829 | Kyla D'angelo | Internal Medicine | 1260 Silas Deane Hwy Ste 109, Wethersfield, CT 06109-4363 | 2014-03-26 |
| 1598100869 | Seabright Cardiovascular Center, LLC | Internal Medicine | 353 Bridgeport Ave, Milford, CT 06460 | 2013-05-01 |
| 1427311711 | Qurat-ul-ain Jelani | Internal Medicine | Section of Cardiovascular Medicine., Yale New Haven Hospital. 20. York Street, New Haven, CT 06510 | 2012-06-21 |
| 1760744643 | Michael M Cebrik | Internal Medicine | 4 Oxford Court, Avon, CT 06001-4556 | 2012-06-15 |
| 1467710657 | Andrew Beck | Internal Medicine | 112 Quarry Rd Ste 400, Trumbull, CT 06611-4877 | 2012-04-25 |
| 1316203482 | James J Purcell | Internal Medicine | 31 Woodland Street, Apt. 4p, Hartford, CT 06105 | 2012-04-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.