COASTAL IMAGING LLC NPI 1366475766

NPI Information

NPI: 1366475766
Provider Name: COASTAL IMAGING LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
565 LONG HILL RD
GROTON, CT
ZIP 06340
Phone: (860) 448-6094
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COASTAL IMAGING LLC is a diagnostic radiology radiology in Groton, CT. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. COASTAL IMAGING LLC NPI is 1366475766. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

565 LONG HILL RD
GROTON, CT
ZIP 06340-166
Phone: (860) 448-6094
Fax: (860) 448-6215

The provider's authorized official is Jay Duxin .
The authorized official title is Physician/owner and has the following contact phone number (860) 448-6094.

The enumeration date for this NPI number is 7/9/2006 and was last updated on 11/6/2013.

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
1	2085R0202X	Radiology	Diagnostic Radiology	033667	CONNECTICUT	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	004234845	MEDICAID	CONNECTICUT
2	C02988	MEDICARE PIN	CONNECTICUT

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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