Organization · NPI-2

Connecticut Surgical Group, PC

Durable Medical Equipment & Medical Supplies · Farmington, CT

NPI number1104988609

StatusActive

Last updated in NPPESAug 11, 2010

Details

NPI: 1104988609
Entity type: Organization (NPI-2)
Legal business name: Connecticut Surgical Group, PC
Organization subpart: No
Enumeration date: Dec 14, 2006
Last updated: Aug 11, 2010

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
332B00000X	Durable Medical Equipment & Medical Supplies	–	–	Yes
2086S0122X	Surgery, Plastic and Reconstructive Surgery	–	–
2086X0206X	Surgery, Surgical Oncology	–	–
208800000X	Urology	–	–
208C00000X	Colon & Rectal Surgery	–	–
213E00000X	Podiatrist	–	–
213ES0103X	Podiatrist, Foot & Ankle Surgery	–	–
208200000X	Plastic Surgery	–	–
2082S0105X	Plastic Surgery, Surgery of the Hand	–	–
208600000X	Surgery	–	–
2086S0105X	Surgery, Surgery of the Hand	–	–

Practice location

399 Farmington Ave
Suite 200
Farmington, CT 06032-1943

Phone 860-246-2071 · Fax 860-674-4260

Mailing address

17 Talcott Notch Rd
Farmington, CT 06032-1818

Phone 860-246-2071 · Fax 860-674-4260

Authorized official

Douglas C Mckell
Chief Administrative Officer
8605244326

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