Healthcare Provider Details

I. General information

NPI: 1235106444
Provider Name (Legal Business Name): NEW BRITAIN RADIOLOGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 12/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GRAND ST
NEW BRITAIN CT
06050
US

IV. Provider business mailing address

101 N PLAINS INDUSTRIAL RD
WALLINGFORD CT
06492-2360
US

V. Phone/Fax

Practice location:
  • Phone: 203-949-2700
  • Fax:
Mailing address:
  • Phone: 203-949-2700
  • Fax: 203-949-2712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SIDNEY ULREICH
Title or Position: PRESIDENT
Credential: MD
Phone: 203-949-2700