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Organization

U. S. COAST GUARD ACADEMY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAY A CHANEY (CLINIC ADMINISTRATOR)
(860) 701-6736
Entity
Organization

Contact information

Practice address
15 MOHEGAN AVE, NEW LONDON, CT 06320-8100
(860) 444-8402
Mailing address
15 MOHEGAN AVE, NEW LONDON, CT 06320-8100

Taxonomy

Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary

Other

Enumeration date
10/03/2006
Last updated
08/22/2020
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