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Organization

DIABETES AND ENDOCRINOLOGY OF NORTHWESTERN CONNECTICUT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EGILS KNUTS BOGDANOVICS M.D. (OWNER)
(860) 496-2198
Entity
Organization

Contact information

Practice address
780 LITCHFIELD ST, TORRINGTON, CT 06790-6268
(860) 496-2198
(860) 489-2482
Mailing address
780 LITCHFIELD ST, TORRINGTON, CT 06790-6268
(860) 496-2198
(860) 489-2482

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001312660
CT
01
3000
NEIC SITE ID, NSF BAO-7
CT
01
4311104
AETNA EDI ID
CT
01
7133354
AETNA CLAIMS ID
CT
Enumeration date
10/11/2006
Last updated
11/09/2012
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