Organization
PATHOLOGY CONSULTANTS OF NEW LONDON, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA VICTORIA G REYES M.D. (PRESIDENT)
(203) 397-8000
Entity
Organization
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 444-5100
(860) 444-3709
Mailing address
PO BOX 902, NEW HAVEN, CT 06504-0902
(203) 397-8000
(203) 389-1540
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004121133
—
CT
01
—
032344
HEALTHNET GROUP#
CT
01
—
2116927
AETNA/US HLTH GROUP#
CT
01
—
3193248
CIGNA GROUP#
CT
01
—
500HBL160CT01
BC/BS GROUP#
CT
01
—
744026
CONNECTICARE GROUP#
CT
01
—
C009155
TRI-CARE/CHAMPUS GROUP#
CT
Enumeration date
07/05/2006
Last updated
10/24/2014
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