Evergreen Endoscopy Center, LLC
NPI #1093974602 in South Windsor, Connecticut
Provider Information
- NPI Number
- 1093974602
- Entity Type
- Organization
- Organization Name
- Evergreen Endoscopy Center, LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Jun 9, 2008
- Last Updated
- Nov 15, 2017
Practice Location
- Address
- 2400 TAMARACK AVENUE
- Address 2
- SUITE 100
- City
- South Windsor
- State
- Connecticut
- ZIP Code
- 06074
- Phone
- (860) 644-7336
Authorized Official
- Name
- WILLIAM A WOLLMAN
- Title
- EXECUTIVE DIRECTOR
- Phone
- (860) 533-2123
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Endoscopy — Endoscopy |
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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