Provider Demographics
NPI:1891817276
Name:CONNECT PHSICIANS' AND SURGICAL SUPPLIES INC.
Entity Type:Organization
Organization Name:CONNECT PHSICIANS' AND SURGICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:203-838-2354
Mailing Address - Street 1:14 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-4711
Mailing Address - Country:US
Mailing Address - Phone:203-838-2354
Mailing Address - Fax:203-857-4202
Practice Address - Street 1:14 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-4711
Practice Address - Country:US
Practice Address - Phone:203-838-2354
Practice Address - Fax:203-857-4202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0679084-000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0489360001Medicare ID - Type Unspecified