Organization
GENERAL SURGICAL ASSOCIATES OF N.L., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAN NORMAN WILLIS M.D. (PRESIDENT/MD)
(860) 443-3147
Entity
Organization
Contact information
Practice address
50 FAIR HARBOUR PL, SUITE 2-C, NEW LONDON, CT 06320-4731
(860) 443-3147
(860) 443-0087
Mailing address
50 FAIR HARBOUR PL, SUITE 2-C, NEW LONDON, CT 06320-4731
(860) 443-3147
(860) 443-0087
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004394558
—
CT
01
—
C14779
RAILROAD MEDICARE
CT
Enumeration date
10/03/2006
Last updated
05/08/2009
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