Dagostino, Mark A
Dagostino, Mark A is an individual health care provider with primary practice located at 1 Long Wharf Dr Suite 302, New Haven CT 06511-5991. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Pediatric Otolaryngology, Allopathic & Osteopathic Physicians / Otolaryngic Allergy. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Dagostino, Mark A can be contacted via phone (203) 776-1288.Contact Information
Primary practice address
1 Long Wharf Dr Suite 302
New Haven CT 06511-5991
Phone: (203) 776-1288
Fax: (203) 776-7741
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 034314 | Connecticut |
| Allopathic & Osteopathic Physicians / Pediatric Otolaryngology | 207YP0228X | 034314 | Connecticut |
| Allopathic & Osteopathic Physicians / Otolaryngic Allergy | 207YX0602X | 034314 | Connecticut |
Profile Details
| NPI number | 1144230749 |
|---|---|
| LBN Legal business name | Dagostino, Mark A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 8th, 2006 |
| Last updated | Jul 2nd, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144230749 | NPPES |
| Connecticut | Other | 040011092 | RAILROAD MEDICARE PIN |
| Connecticut | MEDICAID | 001343144 | RAILROAD MEDICARE PIN |
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