Individual
JAMES O MENZOIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-3540
(860) 679-1390
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
043136
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1431361
—
CT
Enumeration date
06/23/2005
Last updated
06/28/2012
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