Provider Demographics
NPI:1598986796
Name:CONNECTICUT NEUROSURGERY, PC
Entity Type:Organization
Organization Name:CONNECTICUT NEUROSURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-389-2278
Mailing Address - Street 1:330 ORCHARD ST
Mailing Address - Street 2:SUITE 316
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4417
Mailing Address - Country:US
Mailing Address - Phone:203-781-3400
Mailing Address - Fax:203-781-3414
Practice Address - Street 1:1 BRADLEY RD
Practice Address - Street 2:SUITE 501
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2285
Practice Address - Country:US
Practice Address - Phone:203-389-2278
Practice Address - Fax:203-389-2643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT34941332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1477568053OtherNPI
CT1710993381OtherNPI
CT1295741825OtherNPI
CT1649286220OtherNPI
CT1831127265OtherNPI
CT1548275092OtherNPI
CT1659387256OtherNPI
CT1356357933OtherNPI
CT1417962093OtherNPI
CT1952317521OtherNPI