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General NPI Number Information
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NPI Number | 1558418707
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Entity Type | Organization
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Legal Business Name | NORWICH ENDOCRINOLOGY LLC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 119 SACHEM ST
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City | NORWICH
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State | CT
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Zip | 06360-4128
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Country | US
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Telephone | 860-859-3006
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Fax | 860-859-1222
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Provider Business Mailing Address
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Address Line | 119 SACHEM ST
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City | NORWICH
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State | CT
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Zip | 06360-4128
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Country | US
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Telephone | 860-859-3006
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Fax | 860-859-1222
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Authorized Official
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Title or Position | OWNER
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Name | CONSTANTIN CARSELI
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Credential | MD
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Telephone | 860-859-3006
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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 | 040484
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License Number State | CT
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