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Organization
THOMPSON MEDICAL LLC
Active
Organization
THOMPSON MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA A CODERRE (OFFICE MANAGER)
(860) 923-1181
Entity
Organization
Contact information
Practice address
415 RIVERSIDE DR, NORTH GROSVENORDALE, CT 06255-2165
(860) 923-1190
(860) 923-0134
Mailing address
415 RIVERSIDE DR, NORTH GROSVENORDALE, CT 06255-2165
(860) 923-1190
(860) 923-0134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/23/2014
Last updated
11/25/2024
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