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General NPI Number Information
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NPI Number | 1407944689
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Entity Type | Organization
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Legal Business Name | DIABETES AND ENDOCRINOLOGY OF NORTHWESTERN CONNECTICUT
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 780 LITCHFIELD ST
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City | TORRINGTON
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State | CT
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Zip | 06790-6268
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Country | US
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Telephone | 860-496-2198
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Fax | 860-489-2482
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Provider Business Mailing Address
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Address Line | 780 LITCHFIELD ST
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City | TORRINGTON
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State | CT
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Zip | 06790-6268
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Country | US
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Telephone | 860-496-2198
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Fax | 860-489-2482
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Authorized Official
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Title or Position | OWNER
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Name | DR. EGILS KNUTS BOGDANOVICS
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Credential | M.D.
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Telephone | 860-496-2198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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