Organization
CONNECTICUT GASTROENTEROLOGY CONSULTANTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C BENNICK M.D. (PRESIDENT)
(203) 777-0304
Entity
Organization
Contact information
Practice address
40 TEMPLE ST, SUITE 4A, NEW HAVEN, CT 06510-2715
(203) 777-0304
(203) 401-4687
Mailing address
40 TEMPLE ST, SUITE 4A, NEW HAVEN, CT 06510-2715
(203) 777-0304
(203) 401-4687
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004001541
—
CT
Enumeration date
06/01/2007
Last updated
02/13/2012
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