| Organization Name: | UMS CONNECTICUT LITHOTRIPSY, LP |
| NPI Number: | 1205124930 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JORGEN MADSEN (CEO) |
| Mailing Address: | 1500 W Park Dr Ste 390 Westborough |
| State: | MA US |
| Postal Code: | 015813934 |
| Phone Number: | 5088706565 |
| Fax Number: | 5088701563 |
| NPI Enumeration Date: | 07/15/2011 |
| NPI Last Update Date: | 07/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QL0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Lithotripsy |
| Taxonomy Definition: | |