Healthcare Provider Details

I. General information

NPI: 1972504686
Provider Name (Legal Business Name): THE CARDIOLOGY GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 11/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1952 WHITNEY AVE
HAMDEN CT
06517-1209
US

IV. Provider business mailing address

1952 WHITNEY AVE
HAMDEN CT
06517-1209
US

V. Phone/Fax

Practice location:
  • Phone: 203-773-3055
  • Fax: 203-281-5796
Mailing address:
  • Phone: 203-773-3055
  • Fax: 203-281-5796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LEONARD E GRAUER
Title or Position: PRESIDENT
Credential: MD
Phone: 203-773-3055