Coastal Imaging LLC
Organization Active NPI Diagnostic Radiology Physician · Groton, CT
NPI 1366475766 · NPPES record last updated Nov 6, 2013
Key facts
- NPI
- 1366475766
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 033667 (CT)
- Legal business name
- COASTAL IMAGING LLC
- Practice address
- 565 Long Hill Rd
Groton, CT 06340-4166 - Phone
- (860) 448-6094
- Fax
- (860) 448-6215
- NPI assigned
- Jul 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Jay Duxin, M.D.
- Title
- Physician/Owner
- Phone
- (860) 448-6094
Practitioners 8
-
Julie Steiner Gershon, M.D.
-
Richard Dennis Glisson, D.O.
-
Paul David Cardi, MD
-
Kenneth Kay Hines, M.D.
National Provider Directory
Locations
565 Long Hill Rd
Ste 5
Groton, CT 06340
Phone (860) 448-6736
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | 033667 | CT | Yes |
Addresses
Primary practice location
565 Long Hill Rd
Groton, CT 06340-4166
Mailing address
565 Long Hill Rd
Groton, CT 06340-4166
Phone (860) 448-6094
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004234845 | Medicaid | CT |
Other providers in Groton, CT
- Katheryn Jeanne Cloud
- Cloutier Family Practice LLC
- Josee Diane Cloutier
- Acea Cluff
- Coastal Counseling LLC
- Coastal Therapy, LLC
- Patrick Coke Jr.
- Carl Branyon Coker
- Lauri Nyman Cole
- Willie J. Coleman Jr.
All providers in Groton, CT · Diagnostic Radiology Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.