State of Connecticut

NPI #1871524678 in Southbury, Connecticut

Provider Information

NPI Number: 1871524678
Entity Type: Organization
Organization Name: State of Connecticut
Primary Specialty: Ambulance
Enumeration Date: Jul 6, 2006
Last Updated: Sep 27, 2018

Practice Location

Address: ROUTE 172
Address 2: DEPT OF MENTAL RETARDATION: SOUTHBURY TRAINING SCHOOL
City: Southbury
State: Connecticut
ZIP Code: 06488-0901
Phone: (203) 586-2621

Authorized Official

Name: KATHRYN M HANEWICZ
Title: ASSISTANT REGIONAL DIRECTOR
Phone: (203) 586-2518

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ambulance	341600000X	Primary

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