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General NPI Number Information
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NPI Number | 1609882141
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Entity Type | Organization
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Legal Business Name | NEW BRITAIN UROLOGICAL GROUP PC
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 40 HART STREET BLDG-A
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1771
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Country | US
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Telephone | 860-225-6459
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Fax | 860-223-3341
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Provider Business Mailing Address
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Address Line | PO BOX 847
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City | NEW BRITAIN
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State | CT
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Zip | 06050-0847
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Country | US
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Telephone | 860-225-6459
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Fax | 860-223-3341
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. SUEANN M HOLT
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Credential |
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Telephone | 860-225-6459
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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 |
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License Number State |
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