| Diabetes And Endocrinology Of Northwestern Connecticut | |
|
780 Litchfield St Torrington CT 06790-6268 | |
| (860) 496-2198 | |
| (860) 489-2482 |
| Full Name | Diabetes And Endocrinology Of Northwestern Connecticut |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 780 Litchfield St, Torrington, Connecticut |
| Authorized Official Name and Position | Egils Knuts Bogdanovics (OWNER) |
| Authorized Official Contact | 8604962198 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes And Endocrinology Of Northwestern Connecticut 780 Litchfield St Torrington CT 06790-6268 Ph: (860) 496-2198 | Diabetes And Endocrinology Of Northwestern Connecticut 780 Litchfield St Torrington CT 06790-6268 Ph: (860) 496-2198 |
| NPI Number | 1407944689 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 11/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407944689 | NPI | - | NPPES |
| 7133354 | Other | CT | AETNA CLAIMS ID |
| 4311104 | Other | CT | AETNA EDI ID |
| 3000 | Other | CT | NEIC SITE ID, NSF BAO-7 |
| 001312660 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
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