National Provider Identifier Database

CONNECTICUT SURGICAL GROUP PC
Vascular & Interventional Radiology

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.


Contact Information

CONNECTICUT SURGICAL GROUP, PC
680 SOUTH MAIN STREET
LOWER LEVEL 2
CHESHIRE, CT06410-3190
Phone: 203-238-1241
Fax: 203-686-0791
Website:
Specialty Taxonomy Code
* Vascular & Interventional Radiology 2085R0204X
Durable Medical Equipment & Medical Supplies 332B00000X
Prosthetic/Orthotic Supplier 335E00000X

* Indicates primary specialty

NPI Profile & details for CONNECTICUT SURGICAL GROUP, PC

NPI Number 1922170786
Legal business name
LBN
CONNECTICUT SURGICAL GROUP, PC
Authorized official DOUGLAS MCKELL - (CHIEF ADMINISTRATIVE OFFICER)
Entity Organization
Organization subpart No
Enumeration date 11/15/2006
Last updated 03/02/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • CT Medicaid: 004139350
  • MA Medicaid: 9781188
  • CT Other: 87090 AETNA
  • CT Other: 50CONNSURCT01 ANTHEM BCBS
  • CT Other: 0000S02059 CSMS-IPA
  • CT Other: G384943 OXFORD

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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