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General NPI Number Information
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NPI Number | 1285771063
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Entity Type | Organization
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Legal Business Name | CONTINENTAL CONTINENCE CENTER
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 120 PARK LANE RD
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City | NEW MILFORD
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State | CT
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Zip | 06776-2444
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Country | US
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Telephone | 860-354-3584
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Fax | 860-350-9069
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Provider Business Mailing Address
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Address Line | PO BOX 1317
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City | NEW MILFORD
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State | CT
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Zip | 06776-1317
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Country | US
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Telephone | 860-354-3584
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN C YU
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Credential | M.D.
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Telephone | 860-354-3584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 032839
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License Number State | CT
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