Organization
CONNECTICUT PLASTIC SURGERY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TITO L. VASQUEZ MD (PHYSICIAN/MANAGER)
(203) 292-8119
Entity
Organization
Contact information
Practice address
2600 POST RD, SOUTHPORT, CT 06890-1258
(203) 292-8119
(203) 292-8120
Mailing address
2600 POST RD, SOUTHPORT, CT 06890-1258
(203) 292-8119
(203) 292-8120
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
046169
CT
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
046169
CT
Other
Enumeration date
01/26/2009
Last updated
10/26/2009
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