| Gastroenterology Specialty Group, Llc | |
|
115 Technology Dr Ste B-106 Trumbull CT 06611-1395 | |
| (203) 452-1411 | |
| (203) 452-1412 |
| Full Name | Gastroenterology Specialty Group, Llc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 115 Technology Dr, Trumbull, Connecticut |
| Authorized Official Name and Position | Tarun K Gupta (PHYSICIAN) |
| Authorized Official Contact | 2034521411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Specialty Group, Llc 115 Technology Dr Ste B-106 Trumbull CT 06611-1395 Ph: (203) 452-1411 | Gastroenterology Specialty Group, Llc 115 Technology Dr Ste B-106 Trumbull CT 06611-1395 Ph: (203) 452-1411 |
| NPI Number | 1548207970 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 04/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548207970 | NPI | - | NPPES |
| 032684 | Other | CT | CONNECTICARE PROVIDER NUM |
| OV6284 | Other | CT | HEALTHNET PROV. # |
| 001326843 | Medicaid | CT | |
| 010032684CT05 | Other | CT | BC PROVIDER NUMBER |
| 110239944 | Other | CT | MEDICARE RAILROAD PROV. # |
| 5373649 | Other | CT | AETNA PROVIDER # |
| P653628 | Other | CT | OXFORD PROVIDER NUMBER |
| 2185309009 | Other | CT | CIGNA PROV. # |
| 88411 | Other | CT | US HEALTHCARE PROV. # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 032684 (Connecticut) | Primary |
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