CONNECTICUT SURGICAL GROUP PC NPI 1700940509

NPI Information

NPI: 1700940509
Provider Name: CONNECTICUT SURGICAL GROUP, PC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
100 HAZARD AVENUE
SUITE 206
ENFIELD, CT
ZIP 06082
Phone: (860) 246-2071
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CONNECTICUT SURGICAL GROUP, PC is a durable medical equipment medical supplies in Enfield, 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 1700940509. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 HAZARD AVENUE
SUITE 206
ENFIELD, CT
ZIP 06082-447
Phone: (860) 246-2071
Fax: (860) 524-2650

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 12/19/2006 and was last updated on 3/2/2011.

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	208200000X	Plastic Surgery		No
2	2082S0105X	Plastic Surgery	Surgery of the Hand	No
3	208600000X	Surgery		No
4	2086S0105X	Surgery	Surgery of the Hand	No
5	2086S0122X	Surgery	Plastic and Reconstructive Surgery	No
6	2086X0206X	Surgery	Surgical Oncology	No
7	208800000X	Urology		No
8	208C00000X	Colon & Rectal Surgery		No
9	213ES0103X	Podiatrist	Foot & Ankle Surgery	No
10	213E00000X	Podiatrist		No
11	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	C02779	MEDICARE PIN	CONNECTICUT
2	87090	OTHER	CONNECTICUT	AETNA
3	C01687	MEDICARE ID-TYPE UNSPECIFIED	CONNECTICUT	GROUP #
4	9781188	MEDICAID	MASSACHUSETTS
5	50CONNSURCT01	OTHER	CONNECTICUT	ANTHEM BCBS
6	004139350	MEDICAID	CONNECTICUT
7	004201034	MEDICAID	CONNECTICUT
8	01926310	MEDICAID	NEW YORK
9	004169711	MEDICAID	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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