Provider Demographics
NPI:1164545810
Name:CLINICAL CENTER FOR NEOPLASTIC DISEASES, P.C.
Entity Type:Organization
Organization Name:CLINICAL CENTER FOR NEOPLASTIC DISEASES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MNAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-735-8783
Mailing Address - Street 1:158 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-1836
Mailing Address - Country:US
Mailing Address - Phone:203-735-8783
Mailing Address - Fax:203-732-3692
Practice Address - Street 1:158 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-1836
Practice Address - Country:US
Practice Address - Phone:203-735-8783
Practice Address - Fax:203-732-3692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Multi-Specialty
Not Answered207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Not Answered207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty