Healthcare Provider Details
I. General information
NPI: 1972683175
Provider Name (Legal Business Name): ASSOCIATED HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/16/2006
Last Update Date: 01/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
59 RUBBER AVE
NAUGATUCK CT
06770-4123
US
IV. Provider business mailing address
59 RUBBER AVE
NAUGATUCK CT
06770-4123
US
V. Phone/Fax
- Phone: 203-723-7445
- Fax: 203-723-4794
- Phone: 203-723-7445
- Fax: 203-723-4794
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RS0010X |
| Taxonomy | Sports Medicine (Internal Medicine) Physician |
| License Number | 000516 |
| License Number State | CT |
VIII. Authorized Official
Name: DR.
CARL
SCHIANO
Title or Position: OWNER
Credential: DC
Phone: 203-723-7445