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Mark D Reardon

Male

Medical Specialty

Certified Registered Nurse Anesthetist

Professional ID

NPI: 1518971076
PECOS ID: 2264423870
Enrollment ID: I20040521000917
Credential(MD, DO, DPM): CNA
Medical School:
Medical School Graduation Year: 2003

Hospital Service

Hospital CCN1: 070021
Business Name (LBN)1: Windham Comm Mem Hosp Hatch Hosp
Hospital CCN2: 070027
Business Name (LBN)2: Manchester Memorial Hospital

Medical Practices

Organization Name: Anesthesia Associates Of Willimantic Pc
Group Practice ID assigned by PECOS: 2163506353
Number of Group Practice member: 54

Location

Address1: 1185 Main St
Address2:
City: Willimantic
State: Connecticut
Zip Code: 06226
Phone Number: (860)423-7558

Medicare

Medicare Assignment: Yes
Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
Used Electronic health record (EHR):