Anchor Health Initiative Corp.
Organization Active NPI Primary Care Clinic/Center · Stamford, CT
NPI 1245773191 · NPPES record last updated Apr 19, 2024
Key facts
- NPI
- 1245773191
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- ANCHOR HEALTH INITIATIVE CORP.
- Practice address
- 30 Myano LN Ste 16
Stamford, CT 06902-4532 - Phone
- (203) 674-1102
- NPI assigned
- Nov 27, 2016
- Organization subpart
- No
Authorized official
- Name
- Patricia Walsh Chadwick
- Title
- Ceo
- Phone
- (203) 698-0676
Other NPIs with the same Medicare PAC ID 1
Subparts reporting this organization as parent 2
Corporate family (same tax ID) 2
Practitioners 11
-
Sharon Marie Alkerstedt, MSN FNP-C
-
Amanda Armijo, APRN
-
Susan Marie Brown, APRN
-
Joseph Xavier Canarie, M.D.
-
Reia Massaro, APRN
-
Daedly Potusek, APRN
-
Lorna M Seybolt, MD
-
Laurel Nicole Slongwhite, M.D.
-
Jennifer Suski, FNP
-
Jonathan Lawrence Quiles, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180206000691 | CT | Part B Supplier - Clinic/Group Practice | 1759641038 |
Receives reassigned benefits from 11 practitioners Practice locations: Hamden, CT; New Haven, CT; Stamford, CT |
National Provider Directory
- Tax ID family
- Anchor Health Initiative Corp
Locations
30 Myano Ln
Stamford, CT 06902
Phone (202) 674-1102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
30 Myano LN Ste 16
Stamford, CT 06902-4532
Mailing address
30 Myano LN Ste 16
Stamford, CT 06902-4532
Other practice location 1
30 Myano Ln
Stamford, CT 06902-4532
Phone (203) 674-1102
Other providers in Stamford, CT
- American Current Care PA PC
- Sharon Amir
- Amsurg Stamford Anesthesia LLC
- Amy Albero LLC
- Elizabeth Anavy
- Anchor Health Initiative Corp.
- Anchor Health Initiative Corp.
- Andee Cantavero, LCSW
- Thalia S Anderen
- David Andersen
All providers in Stamford, CT · Primary Care Clinic/Center in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.