State of Connecticut
NPI #1790974657 in Simsbury, Connecticut
Provider Information
- NPI Number
- 1790974657
- Entity Type
- Organization
- Organization Name
- State of Connecticut
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Oct 17, 2007
- Last Updated
- Jun 14, 2012
Practice Location
- Address
- 381 HOPMEADOW STREET
- City
- Simsbury
- State
- Connecticut
- ZIP Code
- 06070
- Phone
- (860) 651-1669
Authorized Official
- Name
- DENIS C LAFRENIERE, M.D.
- Title
- MEDICAL DIRECTOR
- Phone
- (860) 679-7503
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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