Organization
CT COLONY EMERGENCY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL HARRIS MD (OWNER)
(469) 401-2386
Entity
Organization
Contact information
Practice address
64 ROBBINS ST, WATERBURY, CT 06708-2613
(203) 573-7305
Mailing address
13737 NOEL ROAD, PHILADELPHIA, PA 19101-0189
(469) 401-2386
(214) 712-2444
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
07/20/2012
Last updated
07/09/2014
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