Basic Information
| Provider Information | |||||||||
| NPI: | 1700871621 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NAUGATUCK VALLEY SURGICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 160 ROBBINS ST | ||||||||
| Address2: | |||||||||
| City: | WATERBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037556663 | ||||||||
| FaxNumber: | 2035748436 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 ROBBINS ST | ||||||||
| Address2: | |||||||||
| City: | WATERBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037556663 | ||||||||
| FaxNumber: | 2035748436 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2005 | ||||||||
| LastUpdateDate: | 03/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | BOZZUTO | ||||||||
| AuthorizedOfficialFirstName: | ELIZABETH | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2037556663 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | 0070 | CT | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.