Healthcare Provider Details

I. General information

NPI: 1386823086
Provider Name (Legal Business Name): NEW BRITAIN RADIOLOGICAL ASSOC.,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GRAND STREET
NEW BRITAIN CT
06050-1058
US

IV. Provider business mailing address

100 GRAND STREET P.O. BOX 1058
NEW BRITAIN CT
06050-1058
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-5674
  • Fax: 860-826-4991
Mailing address:
  • Phone: 860-224-5674
  • Fax: 860-826-4991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. SIDNEY ULREICH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 860-827-0071