Provider Demographics
NPI:1982821385
Name:CT PULMONARY, LLC
Entity Type:Organization
Organization Name:CT PULMONARY, LLC
Other - Org Name:GIOSA AND BROWN PULMONARY ASSOCIATES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE/BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOROSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-440-0254
Mailing Address - Street 1:455 LEWIS AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-2121
Mailing Address - Country:US
Mailing Address - Phone:203-238-9446
Mailing Address - Fax:203-238-9447
Practice Address - Street 1:455 LEWIS AVE STE 206
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2121
Practice Address - Country:US
Practice Address - Phone:203-238-9446
Practice Address - Fax:203-238-9447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027134207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004211554Medicaid
CTG05836Medicare UPIN
CTC02697Medicare ID - Type UnspecifiedGROUP PRACTICE NUMBER
CTD76968Medicare UPIN