Pri- Care Express, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

36223 Issued in CT

Legal business name

PRI- CARE EXPRESS, LLC

Practice address

79 Washington Ave
North Haven, CT 06473

Phone

(203) 239-2727

Fax

(203) 643-2081

NPI assigned

May 13, 2015

Last updated

May 13, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Wasserman, MD

Title

Medical Director

Phone

(203) 239-2727

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1750769584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 WASHINGTON AVE",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731704",
            "telephone_number": "203-239-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 WASHINGTON AVE",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "06473",
            "telephone_number": "203-239-2727",
            "fax_number": "203-643-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRI- CARE EXPRESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-13",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "WASSERMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "203-239-2727",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CT",
            "license": "36223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1487680625",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Perla Marlene Polanco, RDN
• Alana Therese Pomarico, MSN, APRN, NP-C
• Christine Porto, LCSW
• Jamie Prefontaine, APRN
• Kriezel Charmel Ersando Presta, PA-C
• Daniel Thomas Price, M.D.
• Melinda Elizabeth Pritz, M.A., LMFT
• Privia Virtual Health - Connecticut PLLC
• Professional Hearing Services, LLC
• Monique Proto, ATR, LPC

• Primary Care Clinic/Center in North Haven, CT
• Providers in North Haven, CT by specialty
• Primary Care Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.