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Contact Information

SOUTHEASTERN PULMONARY ASSOC. PC
155 MONTAUK AVENUE
NEW LONDON, CT06320
 Phone: 860-444-2223
 Fax: 860-440-3153
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SOUTHEASTERN PULMONARY ASSOC. PC

NPI # 1295754273
LBN Legal business name SOUTHEASTERN PULMONARY ASSOC. PC
Authorized official JOHN URBANETTI - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/19/2006
Last updated 01/20/2016 - About 10 years ago
Identifiers
CT License # 022011
CT License # 022057
CT Medicaid 1220110
CT Medicaid 1220573
CT Other 022057 LIC DR ROBERT KELTNER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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