Provider Demographics
NPI:1407159833
Name:CARDIOLOGY ASSOCIATES OF GREATER WATERBURY LLC
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF GREATER WATERBURY LLC
Other - Org Name:CARDIOLOGY ASSOCIATES OF GREATER WATERBURY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD MEMBER OF PHYSICIAN COUNCIL
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOBKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-573-1435
Mailing Address - Street 1:455 CHASE PKWY
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3352
Mailing Address - Country:US
Mailing Address - Phone:203-573-1435
Mailing Address - Fax:203-755-7433
Practice Address - Street 1:455 CHASE PKWY
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-573-1435
Practice Address - Fax:203-755-7433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty