Organization
CARDIOMED OF CONNECTICUT, LLC
Active
Organization
CARDIOMED OF CONNECTICUT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHUMMAD RAZA M.D., F.A.C.C (OWNER)
(203) 371-5189
Entity
Organization
Contact information
Practice address
4695 MAIN ST, SUITE 19, BRIDGEPORT, CT 06606-1802
(203) 371-5189
(203) 372-6365
Mailing address
4695 MAIN ST, SUITE 19, BRIDGEPORT, CT 06606-1802
(203) 371-5189
(203) 372-6365
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036793
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001367938
—
CT
Enumeration date
10/17/2007
Last updated
05/08/2014
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