Organization
LEDGE LIGHT MEDICAL ASSOCATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG R. BUGGELN M.D. (PHYSICIAN/OWNER)
(860) 442-4442
Entity
Organization
Contact information
Practice address
419 MONTAUK AVE, NEW LONDON, CT 06320-4621
(860) 442-4442
(860) 442-4446
Mailing address
196 PARKWAY S, SUITE 304, WATERFORD, CT 06385-1234
(860) 442-7027
(860) 444-0074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
035420
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001354208
—
CT
Enumeration date
06/01/2006
Last updated
09/04/2012
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