Conicella, Albert

Conicella, Albert is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Medical Toxicology, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Conicella, Albert can be contacted via phone (508) 421-1400.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Fax: (508) 421-1490
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Toxicology 207PT0002X 274004 Massachusetts
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 274004 Massachusetts

Profile Details

NPI number 1194111542
LBN Legal business name Conicella, Albert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2015
Last updated Nov 12th, 2020 - about 4 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 1194111542 NPPES
Massachusetts MEDICAID 110118781A

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