Provider Demographics
NPI:1386823086
Name:NEW BRITAIN RADIOLOGICAL ASSOC.,PC
Entity Type:Organization
Organization Name:NEW BRITAIN RADIOLOGICAL ASSOC.,PC
Other - Org Name:MRI OF NEW BRITAIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ULREICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-827-0071
Mailing Address - Street 1:100 GRAND STREET
Mailing Address - Street 2:P.O. BOX 1058
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06050-1058
Mailing Address - Country:US
Mailing Address - Phone:860-224-5674
Mailing Address - Fax:860-826-4991
Practice Address - Street 1:100 GRAND STREET
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06050-1058
Practice Address - Country:US
Practice Address - Phone:860-224-5674
Practice Address - Fax:860-826-4991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC01982Medicare PIN