Healthcare Provider Details

I. General information

NPI: 1982929816
Provider Name (Legal Business Name): CANCER SCREENING CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2010
Last Update Date: 04/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CASTLE HILL RD
PAWCATUCK CT
06379-1958
US

IV. Provider business mailing address

89 CASTLE HILL RD
PAWCATUCK CT
06379-1978
US

V. Phone/Fax

Practice location:
  • Phone: 860-303-9000
  • Fax: 860-599-3479
Mailing address:
  • Phone: 860-303-9000
  • Fax: 860-599-3479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number048178
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number048178
License Number StateCT

VIII. Authorized Official

Name: DR. CLARISSE D CLEMONS FERRARA
Title or Position: OWNER
Credential: MD
Phone: 860-303-9000