Provider Demographics
NPI:1881635712
Name:CONNECTICUT EAR, NOSE & THROAT, SINUS & ALLERGY SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:CONNECTICUT EAR, NOSE & THROAT, SINUS & ALLERGY SPECIALISTS, P.C.
Other - Org Name:LINDENMAN & SCHIFF EAR, NOSE AND THROAT SPECIALISTS, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CIPRIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-574-3777
Mailing Address - Street 1:21 W MAIN ST
Mailing Address - Street 2:ONE EXCHANGE PLACE BLDG-3RD FLOOR
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2013
Mailing Address - Country:US
Mailing Address - Phone:203-574-3777
Mailing Address - Fax:203-755-1708
Practice Address - Street 1:21 W MAIN ST
Practice Address - Street 2:ONE EXCHANGE PLACE BLDG-3RD FLOOR
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2013
Practice Address - Country:US
Practice Address - Phone:203-574-3777
Practice Address - Fax:203-527-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004239077Medicaid
CT004194627Medicaid
CTC01983Medicare ID - Type UnspecifiedGROUP # FOR ALL PROVIDERS