Provider Demographics
NPI:1952351520
Name:CARDIOLOGY ASSOCIATES OF CENTRAL CONNECTICUT,LLC
Entity type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF CENTRAL CONNECTICUT,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:BUGLIARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-265-9831
Mailing Address - Street 1:1062 BARNES RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-6012
Mailing Address - Country:US
Mailing Address - Phone:203-265-9831
Mailing Address - Fax:203-265-2977
Practice Address - Street 1:1062 BARNES RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-6012
Practice Address - Country:US
Practice Address - Phone:203-265-9831
Practice Address - Fax:203-265-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004173473Medicaid
CTDA0436OtherRAILROAD MEDICARE GROUP
CT004173473Medicaid