EASTERN CONNECTICUT ENDOSCOPY CENTER LLC (NPI# 1609864883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609864883 |
| Entity Type | Organization |
| Organization Name | EASTERN CONNECTICUT ENDOSCOPY CENTER LLC |
| Practice Address |
79 Wawecus St Suite 107 Norwich CT 06360-2160 |
| Practice Telephone | 8608867800 |
| Practice Fax Number | 8608867808 |
| Mailing Telephone | 8608867800 |
| Mailing Fax Number | 8608867808 |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2015-01-13 |
| Authorized Official Name | DR. KOLALA SRIDHAR (PRESIDENT BOARD OF DIRECTORS) |
| Authorized Official Telephone | 8608867800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities | ||
| Y | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
0295 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS CT | 351 | 01 | |
| NBC NATIONAL | 351 | 01 | |
| USHC AETNA US HEALTH CARE | 2373165 | 01 | |
| CONNECTICARE | 765560 | 01 | |
| AETNA PPO EPO NAP MC | 2373165 | 01 | |
| CT | MEDICARE RAILROAD | 490004614 | 01 |
| HEALTH NET | IV9845 | 01 | |
| AETNA PHMO POS | 2373165 | 01 | |
| OXFORD | A2114853 | 01 | |
| BCBS FEDERAL | 351 | 01 |
| Street Address |
79 WAWECUS ST SUITE 107 |
| City | NORWICH |
| State | CT |
| Zip Code | 06360-2160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184620064 | Jeffrey P Seltzer | Internal Medicine | 79 Wawecus St, Suite 106, Norwich, CT 06360-2160 | 2005-06-24 |
| 1043697352 | Carl Kammerer | Technician/Technologist | 79 Wawecus St, Suite 105, Norwich, CT 06360-2178 | 2015-05-06 |
| 1407255375 | Patricia Varma | Nurse Practitioner | 79 Wawecus St, Norwich, CT 06360-2160 | 2014-08-17 |
| 1649679697 | Jade Paradis | Nurse Practitioner | 79 Wawecus St, Norwich, CT 06360-2160 | 2014-08-15 |
| 1396151858 | Kristen Farrell | Nurse Practitioner | 79 Wawecus St, Ste. 101, Norwich, CT 06360-2173 | 2014-07-05 |
| 1316280803 | Sang and Sridhar Digestive Disease Consultants LLC | Internal Medicine | 79 Wawecus St, Suite 102, Norwich, CT 06360-2160 | 2013-04-03 |
| 1760790612 | Leslie N Brown | Physician Assistant | 79 Wawecus St, Ste. 101, Norwich, CT 06360-2160 | 2010-09-14 |
| 1316264286 | Sunita Sidhu-buonocore | Internal Medicine | 79 Wawecus St, Suite 101, Norwich, CT 06360-2160 | 2010-04-30 |
| 1356500532 | Shivani Sood | Internal Medicine | 79 Wawecus St, Suite 101, Norwich, CT 06360-2160 | 2008-06-03 |
| 1689846511 | Natalee Simone Sansone | Internal Medicine | 79 Wawecus St, Suite 101, Norwich, CT 06360-2160 | 2008-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1255961561 | Holly M. Renstrom | Driver | 17 Annadell Rd, Norwich, CT 06360 | 2020-01-26 |
| 1609335397 | Chanel Justice | Social Worker | 2 Clinic Drive, Outpatient Clinic for Children, Norwich, CT 06360 | 2019-03-13 |
| 1457700189 | Michelle Pressler | Pharmacist | 634 West Main St, Norwich, CT 06360 | 2016-06-03 |
| 1265895726 | Katie Johnson | Social Worker | 18 Oneco Street, Norwich, CT 06360 | 2016-04-01 |
| 1871956623 | Lori Deslandes-paz | Pharmacist | 372 West Main Street, Norwich, CT 06360 | 2016-03-30 |
| 1336526193 | Keep An Open Mind, LLC | Marriage & Family Therapist | 12 Cass Street, Suite 202, Norwich, DC 06360 | 2015-04-30 |
| 1588084446 | Kinneri Kothari | Ophthalmology | 79 Wawecus St Ste 105, Norwich, CT 06360 | 2014-04-18 |
| 1962746537 | Robin B Smith | Social Worker | 401 W. Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-20 |
| 1063766400 | Colleen Ellen Phillips-white | Social Worker | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-07 |
| Find all providers in zip 06360 | ||||
| Taxonomy Code | 261QE0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Endoscopy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255820544 | Wallingford Endoscopy Center, LLC. | Clinic/Center | 863 N Main Street Ext Ste 300, Wallingford, CT 06492-2434 | 2018-05-02 |
| 1093974602 | Evergreen Endoscopy Center, LLC | Clinic/Center | 2400 Tamarack Avenue, Suite 100, South Windsor, CT 06074 | 2008-06-09 |
| 1043283906 | Naugatuck Valley Endoscopy Center, LLC | Clinic/Center | 1312 West Main St, Waterbury, CT 06708 | 2006-02-10 |
| 1639360712 | Greenwich Endoscopy Center LLC | Clinic/Center | 500 W Putnam Ave, Greenwich, CT 06830-6086 | 2007-08-05 |
| 1326131418 | Endoscopy Center of Connecticut, LLC | Clinic/Center | 1591 Boston Post Rd, Guilford, CT 06437-4335 | 2006-10-02 |
| 1386757854 | Endoscopy Center of Connecticut, LLC | Clinic/Center | 2200 Whitney Ave, Suite 380, Hamden, CT 06518-3691 | 2006-08-17 |
| 1124131636 | Central Connecticut Endoscopy Center | Clinic/Center | 440 New Britain Ave, Plainville, CT 06062-2016 | 2006-08-17 |
Please comment or provide details below to improve the information on EASTERN CONNECTICUT ENDOSCOPY CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.