| Doctor Name: | ANITA L BOURQUE |
| NPI Number: | 1730166109 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 029902 |
| Business Practice Address: | 100 Grand St New Britain, CT - 060522016 |
| Business Phone Number: | 8602245556 |
| Business Fax Number: | |
| Mailing Address: | 1 Liberty Sq, Po Box 217 NEW BRITAIN |
| State: | CT |
| Postal Code: | 060512637 |
| Phone Number: | 8608270071 |
| Fax Number: | 8602295642 |
| NPI Enumeration Date: | 12/28/2005 |
| NPI Last Update Date: | 06/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 029902 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |