National Provider Identifier Database

COTTAGE GROVE CARDIOLOGY PC
Cardiovascular Disease

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.


Contact Information

COTTAGE GROVE CARDIOLOGY, P.C.
711 COTTAGE GROVE ROAD
BLOOMFIELD, CT06002-3060
Phone: 860-242-8756
Fax: 860-242-3052
Website:
Specialty Taxonomy Code
* Cardiovascular Disease 207RC0000X
Family 363LF0000X
Nurse Practitioner 363L00000X

* Indicates primary specialty

NPI Profile & details for COTTAGE GROVE CARDIOLOGY, P.C.

NPI Number 1710935002
Legal business name
LBN
COTTAGE GROVE CARDIOLOGY, P.C.
Authorized official STACY SIMONS - (OFFICE ASSISTANT)
Entity Organization
Organization subpart No
Enumeration date 05/05/2006
Last updated 11/05/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • CT License #: 002892
  • CT License #: 3110
  • CT License #: 5854
  • CT Medicaid: 004090958
  • Other: CA8569 RAILROAD MEDICARE
  • CT Other: C00718 MEDICARE

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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