Provider Demographics
NPI:1619243508
Name:CONNECTICUT DIAGNOSTIC SOLUTIONS INC
Entity Type:Organization
Organization Name:CONNECTICUT DIAGNOSTIC SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-715-4665
Mailing Address - Street 1:500 SUMMER ST
Mailing Address - Street 2:STE 304
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-4301
Mailing Address - Country:US
Mailing Address - Phone:347-715-4665
Mailing Address - Fax:888-789-7114
Practice Address - Street 1:500 SUMMER ST
Practice Address - Street 2:STE 304
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-4301
Practice Address - Country:US
Practice Address - Phone:347-715-4665
Practice Address - Fax:888-789-7114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile