NPIMap

Organization Active NPI

Connecticut Neurosurgery PC

  • Surgical Physician Assistant
  • Woodbridge, CT
National Provider Identifier
1093805079
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
CONNECTICUT NEUROSURGERY PC
Practice address
1 Bradley Rd
Suite 501
Woodbridge, CT 06525-2285
Phone
(203) 389-2278
Fax
(203) 389-2861
NPI assigned
Oct 13, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gary M Bloomgarden, MD
Title
President
Phone
(203) 781-3400

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X
Neurological Surgery Physician 207T00000X
Physical Medicine & Rehabilitation Physician 208100000X

Addresses

Primary practice location

1 Bradley Rd
Suite 501
Woodbridge, CT 06525-2285

Mailing address

330 Orchard St
Suite 316
New Haven, CT 06511-4417
Phone (203) 781-3400

National Provider Directory

National Provider Directory
Tax ID family
Connecticut Neurosurgery PC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1093805079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 ORCHARD ST",
            "address_2": "SUITE 316",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114417",
            "telephone_number": "203-781-3400",
            "fax_number": "203-781-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD",
            "address_2": "SUITE 501",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252285",
            "telephone_number": "203-389-2278",
            "fax_number": "203-389-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT NEUROSURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BLOOMGARDEN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-781-3400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.