Provider Demographics
NPI:1942613930
Name:COASTAL CONNECTICUT RESEARCH LLC
Entity Type:Organization
Organization Name:COASTAL CONNECTICUT RESEARCH LLC
Other - Org Name:CCRSTUDIES.COM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR, MEMBER LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:SPITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-437-7092
Mailing Address - Street 1:342 MONTAUK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4726
Mailing Address - Country:US
Mailing Address - Phone:860-437-7092
Mailing Address - Fax:860-442-7270
Practice Address - Street 1:342 MONTAUK AVE
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4726
Practice Address - Country:US
Practice Address - Phone:860-437-7092
Practice Address - Fax:860-442-7270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0735480261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch