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CONNECTICUT ONCOLOGY GROUP PC NPI 1376533588


NPI Information

NPI: 1376533588
Provider Name: CONNECTICUT ONCOLOGY GROUP, PC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 07D0707295

Address:
536 SAYBROOK RD
MIDDLETOWN, CT
ZIP 06457
Phone: (860) 358-2220
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CONNECTICUT ONCOLOGY GROUP, PC is a family nurse practitioner in Middletown, CT. CONNECTICUT ONCOLOGY GROUP, PC NPI is 1376533588. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

536 SAYBROOK RD
MIDDLETOWN, CT
ZIP 06457-712
Phone: (860) 358-2220
Fax: (860) 358-2222

The provider's authorized official is Susanna Hong .
The authorized official title is Authorized Official and has the following contact phone number (860) 358-2220.

The CLIA number assigned to this NPI record is 07D0707295 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/27/2005 and was last updated on 5/10/2017.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RH0003XInternal MedicineHematology & OncologyNo
2363L00000XNurse PractitionerNo
3363LF0000XNurse PractitionerFamilyYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1004394970MEDICAIDCONNECTICUT
2C01130MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUT

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: 5/5/2024
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