Organization
CARDIOTHORACIC AND VASCULAR GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP R FAZZONE MD (PRESIDENT)
(203) 562-5115
Entity
Organization
Contact information
Practice address
175 SHERMAN AVE, NEW HAVEN, CT 06511-4301
(203) 562-5115
(203) 784-4181
Mailing address
175 SHERMAN AVE, NEW HAVEN, CT 06511-4301
(203) 562-5115
(203) 784-4181
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
05/18/2007
Last updated
09/12/2007
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