CONNECTICUT SURGICAL GROUP PC NPI 1073597415

NPI Information

NPI: 1073597415
Provider Name: CONNECTICUT SURGICAL GROUP, PC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

CLIA Number: 07D2262334

Address:
1 LIBERTY SQ
NEW BRITAIN, CT
ZIP 06051
Phone: (860) 547-0616
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CONNECTICUT SURGICAL GROUP, PC is a durable medical equipment medical supplies in New Britain, CT. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. CONNECTICUT SURGICAL GROUP, PC NPI is 1073597415. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1 LIBERTY SQ
NEW BRITAIN, CT
ZIP 06051-636
Phone: (860) 547-0616
Fax: (860) 524-2655

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 CLIA number assigned to this NPI record is 07D2262334 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/30/2005 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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	208600000X	Surgery		No
2	208800000X	Urology		No
3	208C00000X	Colon & Rectal Surgery		No
4	2086X0206X	Surgery	Surgical Oncology	No
5	208200000X	Plastic Surgery		No
6	213E00000X	Podiatrist		No
7	213ES0103X	Podiatrist	Foot & Ankle Surgery	No
8	2086S0105X	Surgery	Surgery of the Hand	No
9	2086S0122X	Surgery	Plastic and Reconstructive Surgery	No
10	332B00000X	Durable Medical Equipment & Medical Supplies		Yes

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
1	004201034	MEDICAID	CONNECTICUT
2	50CONNSURCT01	OTHER		ANTHEM BCBS
3	004139350	MEDICAID	CONNECTICUT
4	01926310	MEDICAID	NEW YORK
5	1028630007	MEDICARE NSC	CONNECTICUT
6	004169711	MEDICAID	CONNECTICUT
7	C01687	MEDICARE ID-TYPE UNSPECIFIED
8	9781188	MEDICAID	MASSACHUSETTS

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: 4/28/2024

NPI Synchronization or Removal

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