Healthcare Provider Details

I. General information

NPI: 1124367743
Provider Name (Legal Business Name): SOMERS ANESTHESIOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2013
Last Update Date: 02/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CHESTNUT HILL RD
STAFFORD SPRINGS CT
06076-9925
US

IV. Provider business mailing address

99 EAST RIVER DR. SOMERS ANESTHESIOLOGY ASSOCIATES
EAST HARTFORD CT
06108-7301
US

V. Phone/Fax

Practice location:
  • Phone: 860-684-8424
  • Fax: 860-684-8460
Mailing address:
  • Phone: 860-282-4133
  • Fax: 860-289-0742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JAMES J. BRAKONICEKI
Title or Position: PRESIDENT
Credential: MD
Phone: 860-684-8424