# COASTAL CONNECTICUT VASCULAR ASC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Azura Surgery Center Connecticut
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417780172
- **Authorized official:** DR. GREGG MILLER MD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (717) 515-4048

## Contact information

- **Practice address:** 1152 KINGS HIGHWAY CUTOFF, STE 102, FAIRFIELD, CT 06824-5273
- **Practice address phone:** (203) 330-0248
- **Practice address fax:** (203) 330-9730
- **Mailing address:** PO BOX 411955, BOSTON, MA 02241-1955
- **Mailing address phone:** (610) 644-8900
- **Mailing address fax:** (484) 924-0053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/20/2024
- **Last updated:** 06/09/2026