Basic Information
| Provider Information | |||||||||
| NPI: | 1013258664 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW ENGLAND RHEUMATOLOGY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 CASE ST STE 212 | ||||||||
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| City: | NORWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063602222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608599123 | ||||||||
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| Address1: | 12 CASE ST STE 212 | ||||||||
| Address2: | |||||||||
| City: | NORWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063602222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608599123 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2013 | ||||||||
| LastUpdateDate: | 04/09/2013 | ||||||||
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| AuthorizedOfficialLastName: | CHOWDHARY | ||||||||
| AuthorizedOfficialFirstName: | HARJINDER | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 8608599123 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 043737 | CT | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.