SURGICAL CENTER OF CONNECTICUT LLC NPI 1023113701

NPI Information

SURGICAL CENTER OF CONNECTICUT LLC is an ambulatory surgical clinic center in Bridgeport, CT. SURGICAL CENTER OF CONNECTICUT LLC NPI is 1023113701. The provider is registered as an organization entity type.

The provider's business location address is:

4920 MAIN ST
BRIDGEPORT, CT
ZIP 06606-300
Phone: (203) 371-2986
Fax: (203) 371-2987

The provider's authorized official is Charles A Wallace .
The authorized official title is Administrator and has the following contact phone number (203) 371-2986.

The CLIA number assigned to this NPI record is 07D1080973 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/14/2006 and was last updated on 7/28/2015.

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:

Other Identifiers

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

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