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Organization

EILEEN C. COMIA, MD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EILEEN CRUZ COMIA MD (OWNER)
(860) 242-2200
Entity
Organization

Contact information

Practice address
35 JOLLEY DR, SUITE 102, BLOOMFIELD, CT 06002-3062
(860) 242-2200
(860) 242-2212
Mailing address
35 JOLLEY DR, SUITE 102, BLOOMFIELD, CT 06002-3062
(860) 242-2200
(860) 242-2212

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
363L00000X
Nurse Practitioner
001184
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001359050
CT
01
010035905CT06
ANTHEM
CT
01
C03656
MEDICARE PTAN
CT
Enumeration date
01/24/2007
Last updated
04/03/2015
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