Ciardella, Anthony Dominick

Ciardella, Anthony Dominick is an individual health care provider with primary practice located at 360 14 N Main St , Southington CT 06489. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ciardella, Anthony Dominick can be contacted via phone (860) 621-6759.

Contact Information

Primary practice address
360 14 N Main St Southington CT 06489
Fax: (860) 621-0117
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 024620 Connecticut

Profile Details

NPI number 1184784126
LBN Legal business name Ciardella, Anthony Dominick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2006
Last updated Jul 8th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184784126 NPPES
Connecticut MEDICAID 001246206

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