Individual
CAROLYN AJEMIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
385 MAIN ST SOUTH, UNION SQUARE, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Mailing address
385 MAIN ST SOUTH, C/O NVRA IMAGING NETWORK UNION SQUARE BLDG #1, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
038039
CT
2085R0202X
Diagnostic Radiology Physician
Primary
038039
CT
2085U0001X
Diagnostic Ultrasound Physician
038039
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001380394
—
CT
01
—
300003221
MEDICARE ID - PDI
CT
Enumeration date
07/07/2006
Last updated
06/17/2021
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