Healthcare Provider Details

I. General information

NPI: 1083804231
Provider Name (Legal Business Name): CONNECTICUT COLON & RECTAL SURGERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 HART ST STE B2
NEW BRITAIN CT
06052-1745
US

IV. Provider business mailing address

40 HART ST STE B2
NEW BRITAIN CT
06052-1745
US

V. Phone/Fax

Practice location:
  • Phone: 860-826-3880
  • Fax: 860-826-3883
Mailing address:
  • Phone: 860-826-3880
  • Fax: 860-826-3883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINA CZYRKO
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 860-826-3880