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General NPI Number Information
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NPI Number | 1114021466
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Entity Type | Organization
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Legal Business Name | CONNECTICUT MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 09/30/2008
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Provider Practice Location Address
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Address Line | 1825 BARNUM AVE SUITE 203
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City | STRATFORD
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State | CT
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Zip | 06614
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Country | US
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Telephone | 203-377-5493
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Fax | 203-380-0874
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Provider Business Mailing Address
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Address Line | 1825 BARNUM AVE
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City | STRATFORD
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State | CT
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Zip | 06614-5333
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Country | US
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Telephone | 203-377-5493
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Fax | 203-380-0874
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DENISE MARIE ALLEN
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Credential |
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Telephone | 203-377-5943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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