Provider Demographics
NPI:1225002496
Name:MANSFIELD CARDIOVASCULAR CARE LLC
Entity Type:Organization
Organization Name:MANSFIELD CARDIOVASCULAR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANTHEA
Authorized Official - Middle Name:FIONA
Authorized Official - Last Name:WOODLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-423-9207
Mailing Address - Street 1:PO BOX 440
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06250
Mailing Address - Country:US
Mailing Address - Phone:860-423-9207
Mailing Address - Fax:860-423-9983
Practice Address - Street 1:6 STORRS RD
Practice Address - Street 2:SUITE 6
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226
Practice Address - Country:US
Practice Address - Phone:860-423-9207
Practice Address - Fax:860-423-9983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty