Provider Demographics
NPI:1740311059
Name:VASCULAR ASSOCIATES OF CT, LLC
Entity type:Organization
Organization Name:VASCULAR ASSOCIATES OF CT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:RUBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-246-4000
Mailing Address - Street 1:1000 ASYLUM AVE STE 2120
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1770
Mailing Address - Country:US
Mailing Address - Phone:860-246-4000
Mailing Address - Fax:860-527-6985
Practice Address - Street 1:1000 ASYLUM AVE STE 2120
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1770
Practice Address - Country:US
Practice Address - Phone:860-246-4000
Practice Address - Fax:860-527-6985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02247Medicare ID - Type UnspecifiedMEDICARE GROUP ID