Organization
BLOOMFIELD ASC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARISSA BEAULIEU (ADMINISTRATOR)
(860) 242-2193
Entity
Organization
Contact information
Practice address
580 COTTAGE GROVE RD, SUITE 103, BLOOMFIELD, CT 06002-3088
(914) 556-6266
(860) 955-2957
Mailing address
580 COTTAGE GROVE RD STE 211, BLOOMFIELD, CT 06002-3088
(860) 242-2193
(860) 242-4069
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0350
CT
Other
Enumeration date
01/13/2016
Last updated
12/21/2020
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