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General NPI Number Information
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NPI Number | 1235348145
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR PHYSICIANS, PC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2800 MAIN ST
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4201
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Country | US
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Telephone | 203-576-5708
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Fax | 203-367-8392
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Provider Business Mailing Address
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Address Line | PO BOX 166
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City | SHELTON
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State | CT
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Zip | 06484-0166
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Country | US
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Telephone | 203-225-0247
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Fax | 203-225-0248
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL M. ROSE
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Credential | M.D.
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Telephone | 203-576-5708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 029101
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License Number State | CT
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