Organization
SOUTHEASTERN CT NEPHROLOGY ASSOC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY M. GINSBERG M.D. (PRESIDENT)
(860) 367-0087
Entity
Organization
Contact information
Practice address
88 NORWICH NEW LONDON TPKE, SUITE 2, UNCASVILLE, CT 06382-2518
(860) 367-0087
(860) 367-0117
Mailing address
88 NORWICH NEW LONDON TPKE, SUITE 2, UNCASVILLE, CT 06382-2518
(860) 367-0087
(860) 367-0117
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
003528
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467655225
NPI
CT
Enumeration date
10/24/2013
Last updated
10/24/2013
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