Provider Demographics
NPI:1578643672
Name:STONE, GOLDENBERG & DHARAN LLP
Entity type:Organization
Organization Name:STONE, GOLDENBERG & DHARAN LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:I
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-242-5580
Mailing Address - Street 1:580 COTTAGE GROVE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3088
Mailing Address - Country:US
Mailing Address - Phone:860-242-5580
Mailing Address - Fax:860-243-9701
Practice Address - Street 1:580 COTTAGE GROVE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3088
Practice Address - Country:US
Practice Address - Phone:860-242-5580
Practice Address - Fax:860-243-9701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001214253Medicaid
CT001253558Medicaid
CT001214253Medicaid