Organization
EASTERN CONN. CARDIOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN S. EHRLICH M.D. (PRESIDENT)
(860) 443-4383
Entity
Organization
Contact information
Practice address
196 PARKWAY S, SUITE 103, WATERFORD, CT 06385-1234
(860) 443-4383
(860) 443-3980
Mailing address
196 PARKWAY S, SUITE 103, WATERFORD, CT 06385-1234
(860) 443-4383
(860) 443-3980
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004047577
—
CT
01
—
CJ0983
RR MEDICARE
—
Enumeration date
05/18/2006
Last updated
05/31/2011
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