Organization
CANCER CENTER OF CENTRAL CONNECTICUT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN HANSEN (PRACTICE ADMINISTRATOR)
(860) 621-9316
Entity
Organization
Contact information
Practice address
55 MERIDEN AVE, SOUTHINGTON, CT 06489-3237
(860) 621-9316
(860) 620-5526
Mailing address
55 MERIDEN AVE, SOUTHINGTON, CT 06489-3237
(860) 621-9316
(860) 620-5526
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004178209
—
CT
Enumeration date
05/19/2006
Last updated
10/21/2013
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