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General NPI Number Information
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NPI Number | 1912056292
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Entity Type | Organization
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Legal Business Name | BRISTOL CARDIOVASCULAR ASSOCIATES, PC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 22 PINE ST SUITE 304
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City | BRISTOL
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State | CT
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Zip | 06010-6948
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Country | US
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Telephone | 860-582-3235
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Fax | 860-582-0692
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Provider Business Mailing Address
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Address Line | 22 PINE ST SUITE 304
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City | BRISTOL
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State | CT
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Zip | 06010-6948
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Country | US
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Telephone | 860-582-3235
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Fax | 860-582-0692
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KAREN ANDERSON
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Credential |
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Telephone | 860-582-3235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | CT
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