Provider Demographics
NPI:1649332164
Name:CARDIOLOGY ASSOCIATES OF NORWICH, LLC
Entity type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF NORWICH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-886-2679
Mailing Address - Street 1:79 WAWECUS ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2160
Mailing Address - Country:US
Mailing Address - Phone:860-886-2679
Mailing Address - Fax:860-889-2862
Practice Address - Street 1:79 WAWECUS ST
Practice Address - Street 2:SUITE 106
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2160
Practice Address - Country:US
Practice Address - Phone:860-886-2679
Practice Address - Fax:860-889-2862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC01221Medicare ID - Type UnspecifiedGROUP NUMBER