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General NPI Number Information
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NPI Number | 1043607294
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Entity Type | Organization
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Legal Business Name | CTUC03 P.C.
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 100 MILL PLAIN RD
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City | DANBURY
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State | CT
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Zip | 06811-5178
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Country | US
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Telephone | 203-826-2600
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Fax | 203-826-2139
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Provider Business Mailing Address
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Address Line | 100 MILL PLAIN RD
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City | DANBURY
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State | CT
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Zip | 06811-5178
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Country | US
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Telephone | 203-826-2600
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Fax | 203-826-2139
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Authorized Official
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Title or Position | DIRECTOR
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Name | THOMAS KELLY
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Credential |
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Telephone | 860-484-9193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | CT
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