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Organization
DIGESTIVE DISEASE ASSOCIATES ENDOSCOPY SUITE, LLC
Active
Organization
DIGESTIVE DISEASE ASSOCIATES ENDOSCOPY SUITE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DUNBAR ILLICK (PARTNER)
(203) 481-0315
Entity
Organization
Contact information
Practice address
687 MAIN ST, BRANFORD, CT 06405-3612
(203) 481-0315
(203) 488-6945
Mailing address
687 MAIN ST, BRANFORD, CT 06405-3612
(203) 481-0315
(203) 488-6945
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0322
CT
Other
Enumeration date
12/02/2008
Last updated
03/04/2022
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