Provider Demographics
NPI:1285643577
Name:CARDIOTHORACIC AND VASCULAR SURGEONS, P.C.
Entity Type:Organization
Organization Name:CARDIOTHORACIC AND VASCULAR SURGEONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOTHORACICTHORACIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:HIROYOSHI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-522-7181
Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:SUITE 325
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5501
Mailing Address - Country:US
Mailing Address - Phone:860-522-7181
Mailing Address - Fax:860-278-3357
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 325
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-522-7181
Practice Address - Fax:860-278-3357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Not Answered363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCG6782OtherRAILROAD MEDICARE
CT=========OtherANTHEM BLUE CROSS
CTCG6782OtherRAILROAD MEDICARE
CT=========OtherAETNA HMO
CT=========OtherAETNA HEALTHPLAN
CT=========OtherCIGNA HEALTHCARE
CT=========OtherUNITED HEALTHCARE
CT=========OtherHEALTHNET
CT=========OtherRAILROAD MEDICARE
CT=========OtherBLUECARE FAMILY PLAN
CTCG6782OtherRAILROAD MEDICARE