Provider Demographics
NPI:1982839247
Name:CONNECTICUT NEPHROLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:CONNECTICUT NEPHROLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHUGHTAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-237-6700
Mailing Address - Street 1:455 LEWIS AVE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-2121
Mailing Address - Country:US
Mailing Address - Phone:203-237-6700
Mailing Address - Fax:203-237-6100
Practice Address - Street 1:455 LEWIS AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2121
Practice Address - Country:US
Practice Address - Phone:203-237-6700
Practice Address - Fax:203-237-6100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty