Provider Demographics
NPI:1841470820
Name:TOLLAND IMAGING CENTER, LLC
Entity type:Organization
Organization Name:TOLLAND IMAGING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCCONVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-896-4848
Mailing Address - Street 1:71 HAYNES ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4131
Mailing Address - Country:US
Mailing Address - Phone:860-533-2970
Mailing Address - Fax:860-647-6860
Practice Address - Street 1:6 FIELDSTONE CMNS
Practice Address - Street 2:SUITE E
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-3418
Practice Address - Country:US
Practice Address - Phone:860-896-4848
Practice Address - Fax:860-896-4849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty