Organization
COASTAL IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY DUXIN M.D. (PHYSICIAN/OWNER)
(860) 448-6094
Entity
Organization
Contact information
Practice address
565 LONG HILL RD, GROTON, CT 06340-4166
(860) 448-6094
(860) 448-6215
Mailing address
565 LONG HILL RD, GROTON, CT 06340-4166
(860) 448-6094
(860) 448-6215
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
033667
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004234845
—
CT
Enumeration date
07/09/2006
Last updated
11/06/2013
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