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Organization

SHORELINE SURGICAL ASSOC. P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH A COATTI MD (PRESIDENT)
(860) 347-9167
Entity
Organization

Contact information

Practice address
400 SAYBROOK RD, SUITE 110, MIDDLETOWN, CT 06457
(860) 347-9167
(860) 347-1630
Mailing address
400 SAYBROOK RD, SUITE 110, MIDDLETOWN, CT 06457
(860) 347-9167
(860) 347-1630

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2086S0129X
Vascular Surgery Physician
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
363AS0400X
Surgical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004394524
CT
01
CA8575
RAILROAD-MEDICARE
CT
Enumeration date
03/26/2007
Last updated
05/02/2016
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