Organization
COASTAL DIGESTIVE CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN FRESE JR. MD (MEDICAL DIRECTOR)
(860) 442-0290
Entity
Organization
Contact information
Practice address
234A BANK ST, 4TH FLOOR, NEW LONDON, CT 06320
(860) 447-0402
(860) 447-8117
Mailing address
234A BANK ST, 4TH FLOOR, NEW LONDON, CT 06320
(860) 447-0402
(860) 447-8117
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0303
CT
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001168194
—
CT
05
—
001284083
—
CT
05
—
001317975
—
CT
05
—
001385617
—
CT
05
—
004223137
—
CT
Enumeration date
07/07/2006
Last updated
05/07/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us