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General NPI Number Information
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NPI Number | 1871550392
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Entity Type | Organization
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Legal Business Name | CONNECTICUT SURGERY CENTER LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 55 SOUTH RD STE 100
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City | FARMINGTON
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State | CT
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Zip | 06032-2022
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Country | US
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Telephone | 860-247-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 55 SOUTH RD STE 100
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City | FARMINGTON
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State | CT
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Zip | 06032-2022
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Country | US
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Telephone | 860-247-5555
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINSITRATIVE OFFICER
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Name | ANNA GENGEL JR.
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Credential |
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Telephone | 860-810-1361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0270
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License Number State | CT
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