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Organization
CONNECTICUT VALLEY RADIOLOGY, PC
Active
Organization
CONNECTICUT VALLEY RADIOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA A PICHETTE (PRACTICE MANAGER)
(860) 522-1101
Entity
Organization
Contact information
Practice address
19 WOODLAND ST, SUITE 15, HARTFORD, CT 06105-2372
(860) 522-1101
(860) 549-7092
Mailing address
19 WOODLAND ST, SUITE 15, HARTFORD, CT 06105-2372
(860) 522-1101
(860) 549-7092
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
NULL
2085B0100X
Body Imaging Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004187565
—
CT
01
—
15MRI0018CT01
ANTHEM BLUE CROSS AND BLUE SHIEL
CT
Enumeration date
12/03/2010
Last updated
12/03/2010
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