NPIMap

Organization Active NPI

Eastern Conn. Cardiology Group

  • Cardiovascular Disease Physician
  • Waterford, CT
National Provider Identifier
1336192608
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
EASTERN CONN. CARDIOLOGY GROUP
Practice address
196 Parkway S
Suite 103
Waterford, CT 06385-1234
Phone
(860) 443-4383
Fax
(860) 443-3980
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2011

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

Authorized official

Name
Brian S. Ehrlich, M.D.NPI 1659329688
Title
President
Phone
(860) 443-4383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

196 Parkway S
Suite 103
Waterford, CT 06385-1234

Mailing address

196 Parkway S
Suite 103
Waterford, CT 06385-1234
Phone (860) 443-4383

Other identifiers 2

IdentifierTypeStateIssuer
004047577MedicaidCT
CJ0983OtherRR MEDICARE

National Provider Directory

National Provider Directory

Locations

481 Gold Star Hwy
Ste 101
Groton, CT 06340
Phone (860) 446-2167

333 Cedar St
Rm 302
New Haven, CT 06510

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306800000000",
    "number": "1336192608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 103",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-443-4383",
            "fax_number": "860-443-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 103",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-443-4383",
            "fax_number": "860-443-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CONN. CARDIOLOGY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-05-31",
        "status": "A",
        "authorized_official_last_name": "EHRLICH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-443-4383",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004047577",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CJ0983",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.