Organization
WINDHAM SURGICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT W. RIDYARD JR. M.D. (PRESIDENT)
(860) 423-5000
Entity
Organization
Contact information
Practice address
162 MANSFIELD AVE # B, WILLIMANTIC, CT 06226-2041
(860) 423-5000
(860) 423-4838
Mailing address
162 MANSFIELD AVE # B, WILLIMANTIC, CT 06226-2041
(860) 423-5000
(860) 423-4838
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004139318
—
CT
Enumeration date
07/05/2006
Last updated
05/20/2008
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