Provider Demographics
NPI:1538209721
Name:CONNECTICUT HEART GROUP, P.C.
Entity type:Organization
Organization Name:CONNECTICUT HEART GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-867-5300
Mailing Address - Street 1:46 PRINCE ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1600
Mailing Address - Country:US
Mailing Address - Phone:203-867-5300
Mailing Address - Fax:203-315-5320
Practice Address - Street 1:46 PRINCE ST
Practice Address - Street 2:SUITE 310
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1600
Practice Address - Country:US
Practice Address - Phone:203-867-5300
Practice Address - Fax:203-315-5320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004128816Medicaid
CT004128816Medicaid