Organization
EASTERN CONNECTICUT NEUROSURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY R. CRISCUOLO M.D. (OWNER/PRESIDENT)
(860) 859-5137
Entity
Organization
Contact information
Practice address
330 WASHINGTON ST, SUITE 540, NORWICH, CT 06360-2700
(860) 859-5137
(860) 859-5177
Mailing address
7 MOUNTAINCREST DR, CHESHIRE, CT 06410-3554
(860) 859-5137
(860) 859-5177
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
030418
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001304188
—
CT
Enumeration date
01/15/2009
Last updated
01/15/2009
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