Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant | |
Neurological Surgery |
207T00000X | 02 | Physician/General Surgery | |
Pain Medicine |
207LP2900X | 05 | Physician/Anesthesiology | |
Physical Medicine & Rehabilitation |
208100000X | 25 | Physician/Physical Medicine and Rehabilitation |
| NPI # | 1093805079 |
| LBN Legal business name | CONNECTICUT NEUROSURGERY PC |
| Authorized official | GARY BLOOMGARDEN - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 10/13/2006 |
| Last updated | 09/11/2025 - About 9 months ago |
| Identifiers | n/a |
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