Organization
MANDELL & BLAU, MD'S PC
Active
Other names
Open MRI of Middletown
Organization subpart
No
Provider details
NPI number
Authorized official
KIRT FREDERICKSON MD (PRESIDENT)
(203) 241-3470
Entity
Organization
Contact information
Practice address
2 RIVERVIEW DR STE 104, DANBURY, CT 06810-4211
(203) 426-3002
Mailing address
PO BOX 230, GLASTONBURY, CT 06033-0230
(203) 241-3470
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060857
CONNECTICARE
CT
01
—
15MRI0016CT05
ANTHEM BC/BS
CT
01
—
222094
WELLCARE/PREFERRED ONE
CT
01
—
2V0862
HEALTHNET
CT
05
—
4000931
—
CT
01
—
A369503
OXFORD
CT
01
—
CJ5750
RAILROAD MEDICARE
CT
Enumeration date
06/06/2007
Last updated
03/12/2026
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