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CONNECTICUT SURGICAL GROUP PC NPI 1023291622


NPI Information

NPI: 1023291622
Provider Name: CONNECTICUT SURGICAL GROUP, PC
Classification: Urology - 208800000X
Entity Type: Organization
Address:
455 LEWIS AVE
SUITE 210
MERIDEN, CT
ZIP 06451
Phone: (203) 238-1241
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CONNECTICUT SURGICAL GROUP, PC is an urology in Meriden, CT. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. CONNECTICUT SURGICAL GROUP, PC NPI is 1023291622. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

455 LEWIS AVE
SUITE 210
MERIDEN, CT
ZIP 06451-121
Phone: (203) 238-1241
Fax: (203) 686-0791

The provider's authorized official is Douglas C Mckell .
The authorized official title is Chief Administrative Officer and has the following contact phone number (860) 524-4326.

The enumeration date for this NPI number is 12/6/2007 and was last updated on 8/11/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208200000XPlastic SurgeryNo
2208600000XSurgeryNo
32086S0129XSurgeryVascular SurgeryNo
4208C00000XColon & Rectal SurgeryNo
5213E00000XPodiatristNo
6208800000XUrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
150CONNSURCT01OTHERCONNECTICUTANTHEM BCBS
2004139350MEDICAIDCONNECTICUT
31028630012MEDICARE NSCCONNECTICUT
4C01687MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.