Organization
CARDIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES E KALLAL MD (PHYSICIAN PRESIDENT)
(860) 522-5712
Entity
Organization
Contact information
Practice address
100 RETREAT AVE, SUITE 811, HARTFORD, CT 06106-2563
(860) 522-5712
(860) 520-4270
Mailing address
100 RETREAT AVE, SUITE 811, HARTFORD, CT 06106-2563
(860) 522-5712
(860) 520-4270
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
027525
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004052098
—
CT
01
—
604855
TUFTS
—
01
—
CM3450
RAILROAD MEDICARE
—
Enumeration date
08/21/2006
Last updated
11/03/2015
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