# CONNECTICUT VALLEY RADIOLOGY, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518269091
- **Authorized official:** MS. PATRICIA A PICHETTE (PRACTICE MANAGER)
- **Authorized official phone:** (860) 522-1101

## Contact information

- **Practice address:** 19 WOODLAND ST, SUITE 15, HARTFORD, CT 06105-2372
- **Practice address phone:** (860) 522-1101
- **Practice address fax:** (860) 549-7092
- **Mailing address:** 19 WOODLAND ST, SUITE 15, HARTFORD, CT 06105-2372
- **Mailing address phone:** (860) 522-1101
- **Mailing address fax:** (860) 549-7092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | — | NULL | Yes |
| 2085B0100X | Body Imaging Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/03/2010
- **Last updated:** 12/03/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004187565 | — | CT |
| 01 | — | 15MRI0018CT01 | ANTHEM BLUE CROSS AND BLUE SHIEL | CT |