Organization
WESTERN CONNECTICUT THORACIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWN TITTLE (PRESIDENT)
(203) 403-3490
Entity
Organization
Contact information
Practice address
10 SOUTH ST, SUITE 202, RIDGEFIELD, CT 06877-4124
(203) 403-3490
Mailing address
10 SOUTH ST, SUITE 202, RIDGEFIELD, CT 06877-4124
(203) 403-3490
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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