MEDICARE: TOWN OF LEDYARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	590010517	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	CT6659	OTHER	HEALTHNET
2	710C072B1CT01	OTHER	BLUE CROSS/BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245225887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN OF LEDYARD

Provider Business Mailing Address
First Line	:	269 MAIN ST
Second Line	:
City	:	CROMWELL
State	:	CT
Zip	:	06416-2302
Country	:	US
Telephone Number	:	860-638-1800
Fax Number	:	860-638-1802

Provider Business Practice Location Address
First Line	:	741 R COL LEDYARD HIGHWAY
Second Line	:
City	:	LEDYARD
State	:	CT
Zip	:	06339
Country	:	US
Telephone Number	:	860-464-8222
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KATHY IVEY
Credential	:
Telephone Number	:	860-464-8222

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	01/20/2010

Similar Medicare Providers

1790785905 — DR. JAY CLARK HANS AU.D.
Practice Location Address:

7 COACHMAN PIKE
LEDYARD, CT
06339-1305

Practice Phone: 860-464-9779
Practice Fax:

1326027046 — LEDYARD REGIONAL VISITING NURSE AGENCY
Practice Location Address:

741 COLONEL LEDYARD HWY
LEDYARD, CT
06339-1511

Practice Phone: 860-464-8464
Practice Fax: 860-464-7605

1134192420 — MR. JOEL PATRICK LAROSE CRNA
Practice Location Address:

2 OAK HILLS TRL
LEDYARD, CT
06339-1234

Practice Phone: 860-464-5514
Practice Fax: 860-464-5514

1629021860 — SOUND MEDICAL ASSOCIATES, PC
Practice Location Address:

2 LORENZ INDUSTRIAL PARKWAY
LEDYARD, CT
06339-1946

Practice Phone: 860-464-3045
Practice Fax: 860-464-3044

1649352790 — DR. MARILYN ANDERSEN RICHARD APRN
Practice Location Address:

333 COLONEL LEDYARD HWY
LEDYARD, CT
06339-1909

Practice Phone: 860-572-7556
Practice Fax: 860-572-2976

1013093434 — JOY HOLISTIC COUNSELING LLC
Practice Location Address:

1807 CENTER GROTON RD
LEDYARD, CT
06339

Practice Phone: 860-464-9384
Practice Fax: 860-464-9899

Directions to “TOWN OF LEDYARD ” Practice Location

Language	Start Address	Practice Location

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