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Masonicare Health Center
Prosthetic/Orthotic Supplier in Wallingford, Connecticut
NPI 1588638688

Masonicare Health Center is a Prosthetic/Orthotic Supplier based in Wallingford, CT. Masonicare Health Center practices in Wallingford, CT. The NPI Number for Masonicare Health Center is 1588638688 and holds a License No. 0075 (Connecticut).

The current practice location address for Masonicare Health Center is 22 Masonic Ave, Wallingford, CT and can be reached out via phone at 203-679-5900.

Location: 22 Masonic Ave, Wallingford, CT, 06492-3048
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1588638688
Provider Name
Masonicare Health Center
Credential
Provider Entity Type
Organization
Address
22 Masonic Ave, Wallingford, CT, 06492-3048
Phone Number
203-679-5900
Fax Number
Provider Enumeration Date
02/15/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004025425 05 CT
0070177 05 CT
082 01 CT BLUE CROSS
004014791 05 CT
institution
Provider Business Practice Location Address Details
Address
22 Masonic Ave
City
Wallingford
State
Connecticut
Zip
06492-3048
Phone Number
203-679-5900
Fax Number
person
Provider Business Mailing Address Details
Address
22 Masonic Ave
City
Wallingford
State
Connecticut
Zip
06492-3048
Phone Number
203-679-5900
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
0075 (Connecticut)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Ambulatory Surgical
Taxonomy
261QA1903X
License No.
0075 (Connecticut)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Community Health
Taxonomy
261QC1500X
License No.
0075 (Connecticut)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
0075 (Connecticut)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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