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Organization
CANCER CENTER OF CENTRAL CONNECTICUT LLC
Active
Organization
CANCER CENTER OF CENTRAL CONNECTICUT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN HANSEN (PRACTICE ADMINISTRATOR)
(860) 621-9316
Entity
Organization
Contact information
Practice address
55 MERIDEN AVE, SOUTHINGTON, CT 06489-3237
(860) 621-9316
(860) 620-5526
Mailing address
55 MERIDEN AVE, SOUTHINGTON, CT 06489-3237
(860) 621-9316
(860) 620-5526
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004178209
—
CT
Enumeration date
05/19/2006
Last updated
10/21/2013
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