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Contact Information

CONNECTICUT PATHOLOGY GROUP PC
28 CRESCENT ST
MIDDLETOWN, CT06457-3654
 Phone: 860-344-6174
 Fax: 860-344-6062
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for CONNECTICUT PATHOLOGY GROUP PC · (Female)

NPI Number 1740219625
Status Active
Credentials
Entity Individual
Enumeration date 07/02/2006
Last updated 08/17/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • CT License # 016547
  • CT Medicaid 4053021
  • CT Other 0039758 AETNA/USHC GRP#
  • CT Other 500HBL066CT01 BCBS GROUP#
  • CT Other 0077315 CIGNA GRP#
  • CT Other 4832 CONNECTICARE GROUP#
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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