Organization
BRISTOL HOSPITAL CLINICIANS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEONARD BANCO (VICE PRESIDENT)
(860) 585-3906
Entity
Organization
Contact information
Practice address
1 BREWSTER RD, BRISTOL, CT 06010-5142
(860) 585-3000
(860) 585-3907
Mailing address
PO BOX 2828, BRISTOL, CT 06011-2828
(860) 585-3906
(860) 585-3907
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004116001
—
CT
Enumeration date
05/10/2006
Last updated
06/23/2010
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