MEDICARE: EILEEN C COMIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	035905	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7777840121	OTHER	CT	CONNECTICARE
3	010035905CT04	OTHER	CT	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1235233313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN C COMIA MD

Provider Business Mailing Address
First Line	:	35 JOLLEY DR
Second Line	:	SUITE 102
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3062
Country	:	US
Telephone Number	:	860-242-2200
Fax Number	:	860-242-2212

Provider Business Practice Location Address
First Line	:	35 JOLLEY DR
Second Line	:	SUITE 102
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3062
Country	:	US
Telephone Number	:	860-242-2200
Fax Number	:	860-242-2212

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	07/23/2013

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Directions to “ EILEEN C COMIA MD” Practice Location

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