Provider Demographics
NPI:1336131358
Name:CARDIAC & THORACIC SURGICAL ASSOC.
Entity Type:Organization
Organization Name:CARDIAC & THORACIC SURGICAL ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-244-2300
Mailing Address - Street 1:345 N MAIN ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2515
Mailing Address - Country:US
Mailing Address - Phone:860-244-2300
Mailing Address - Fax:860-278-1507
Practice Address - Street 1:345 N MAIN ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2515
Practice Address - Country:US
Practice Address - Phone:860-244-2300
Practice Address - Fax:860-278-1507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004209707Medicaid
CT004209707Medicaid