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Organization
COASTAL DIGESTIVE CARE CENTER LLC
Active
Organization
COASTAL DIGESTIVE CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN FRESE JR. MD (MEDICAL DIRECTOR)
(860) 442-0290
Entity
Organization
Contact information
Practice address
234A BANK ST, 4TH FLOOR, NEW LONDON, CT 06320
(860) 447-0402
(860) 447-8117
Mailing address
234A BANK ST, 4TH FLOOR, NEW LONDON, CT 06320
(860) 447-0402
(860) 447-8117
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0303
CT
261QA1903X
Ambulatory Surgical Clinic/Center
—
NULL
Other
Enumeration date
07/07/2006
Last updated
05/07/2009
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