Healing Edge Medical Associates Llc

LBN: Healing Edge Medical Associates Llc
Healing Edge Medical Associates Llc is an health care organization with primary practice located at 29 Kripes Rd Suite M, East Granby CT 06026-9669. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine. Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine is the primary health care specialty. Healing Edge Medical Associates Llc can be contacted via phone (860) 413-3883, or through Agnes, Ronald Dale via phone (860) 978-8825.

Contact Information

Primary practice address
29 Kripes Rd Suite M East Granby CT 06026-9669
Phone: (860) 413-3883
Fax: (860) 413-3884
Website:
Map and Directions
Authorized official contact:
Name: Agnes, Ronald Dale Doctor of Medicine (MD)
Phone: (860) 978-8825

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036511 Connecticut
Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine 2083P0500X 036511 Connecticut

Profile Details

NPI number 1134450828
LBN Legal business name Healing Edge Medical Associates Llc
DBA Doing business as
Authorized official Agnes, Ronald Dale Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 20th, 2010
Last updated Jun 19th, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134450828 NPPES
Illinois MEDICAID 3097037
Illinois Other J13195

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