Provider Demographics
NPI:1962265934
Name:CT MEDICAL GROUP INC.
Entity type:Organization
Organization Name:CT MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-321-2626
Mailing Address - Street 1:317 FOXON RD
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-2038
Mailing Address - Country:US
Mailing Address - Phone:203-529-3271
Mailing Address - Fax:
Practice Address - Street 1:317 FOXON RD
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-2038
Practice Address - Country:US
Practice Address - Phone:203-529-3271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty