Organization
NORTHEASTERN NEPHROLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELITO C BACAY M.D. (PRESIDENT)
(860) 872-8563
Entity
Organization
Contact information
Practice address
281 HARTFORD TPKE, SUITE 210, VERNON, CT 06066-4784
(860) 872-8563
(860) 870-4857
Mailing address
281 HARTFORD TPKE, SUITE 210, VERNON, CT 06066-4784
(860) 872-8563
(860) 870-4857
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
029990
CT
207RN0300X
Nephrology Physician
029990
CT
Other
Enumeration date
02/07/2007
Last updated
01/23/2012
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