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General NPI Number Information
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NPI Number | 1912917089
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Entity Type | Organization
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Legal Business Name | MIDDLESEX CARDIOLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 420 SAYBROOK RD
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City | MIDDLETOWN
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State | CT
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Zip | 06457
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Country | US
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Telephone | 860-347-4258
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Fax | 860-704-5924
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Provider Business Mailing Address
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Address Line | 420 SAYBROOK RD
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City | MIDDLETOWN
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State | CT
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Zip | 06457-4700
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Country | US
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Telephone | 860-347-4258
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Fax | 860-704-5924
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | ERAN I SHANI
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Credential | MD
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Telephone | 860-347-4258
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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 |
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