NPIMap

Organization Active NPI

Eastern CT Cardiology Diagnostics, LLC

  • Cardiovascular Disease Physician
  • Waterford, CT
National Provider Identifier
1548211188
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 CT CARDIOLOGY DIAGNOSTICS, LLC
Practice address
196 Parkway S
Suite 103
Waterford, CT 06385-1234
Phone
(860) 443-4383
Fax
(860) 443-3980
NPI assigned
May 15, 2006
Last updated
May 31, 2011By the provider in NPPES
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 with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 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
004217130MedicaidCT
CH9157OtherRR MEDICARE

National Provider Directory

National Provider Directory

Locations

365 Montauk Ave
#L
New London, CT 06320
Phone (860) 449-4383

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306800000000",
    "number": "1548211188",
    "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 CT CARDIOLOGY DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "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": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004217130",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CH9157",
            "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.