Primary Physical Medicine LLC
Organization Active NPI Family Nurse Practitioner · Enfield, CT
NPI 1487190013 · NPPES record last updated Jan 31, 2022
Key facts
- NPI
- 1487190013
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 006454 (CT)
- Legal business name
- PRIMARY PHYSICAL MEDICINE LLC
- Practice address
- 143 Hazard Ave
Enfield, CT 06082-4521 - Phone
- (860) 763-2225
- NPI assigned
- Jan 6, 2017
- Organization subpart
- No
Authorized official
- Name
- Kevin E Sadowski, APRN DC
- Title
- Sole Owner
- Phone
- (860) 763-2225
Practitioners 5
-
Kevin E Sadowski, MSN, FNP-C
-
Zoryana Bilohan, APRN
-
Beth A Finn, APRN, FNP
-
Paul Pezzino, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170201002768 | CT | Part B Supplier - Clinic/Group Practice | 8628351467 |
Receives reassigned benefits from 4 practitioners Practice locations: Waterbury, CT; New Britain, CT; Manchester, CT; Hartford, CT; Enfield, CT |
National Provider Directory
Locations
71 E Center St
Manchester, CT 06040
Phone (475) 400-0983
1 Herald Sq
Ste LL1
New Britain, CT 06051
Phone (475) 400-0983
1 Herald Sq
Ste 102
New Britain, CT 06051
1336 W Main St
Ste 1B
Waterbury, CT 06708
Phone (203) 437-7229
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | 006454 | CT | Yes |
Addresses
Primary practice location
143 Hazard Ave
Enfield, CT 06082-4521
Mailing address
143 Hazard Ave
Enfield, CT 06082-4521
Phone (860) 763-2225
Other providers in Enfield, CT
- Lisa M Portal
- Francesca Nicole Porter
- Lynne Porter
- Rich P Prenetta
- Jillian Kay Prescod
- Primary Spine & Rehab LLC
- Renee Prince
- Meghan Provost
- Alexandra Psilos
- Ptsma, Inc.
All providers in Enfield, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2022. 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.