Healthcare Provider Details

I. General information

NPI: 1730837576
Provider Name (Legal Business Name): GREATER CONNECTICUT ANESTHESIA ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 POST RD
FAIRFIELD CT
06824-6232
US

IV. Provider business mailing address

PO BOX 736631
DALLAS TX
75373-6631
US

V. Phone/Fax

Practice location:
  • Phone: 203-292-9000
  • Fax: 727-900-7770
Mailing address:
  • Phone: 888-717-5383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFF PERRY
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 502-418-4700