Organization
UROLOGIC ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ARNOLD FRASER MD (PRESIDENT)
(860) 443-8428
Entity
Organization
Contact information
Practice address
21 MONTAUK AVE, SUITE 304, NEW LONDON, CT 06320-4906
(860) 443-8428
Mailing address
21 MONTAUK AVE, SUITE 304, NEW LONDON, CT 06320-4906
(860) 443-8428
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50UROLOGYCT01
ANTHEM BLUE SHIELD
CT
Enumeration date
10/19/2006
Last updated
08/22/2020
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