Illescas, Fernando F.

Illescas, Fernando F. is an individual health care provider with primary practice located at 701 Cottage Grove Rd Ste E110 , Bloomfield CT 06002-3085. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Illescas, Fernando F. can be contacted via phone (860) 265-2529.

Contact Information

Primary practice address
701 Cottage Grove Rd Ste E110 Bloomfield CT 06002-3085
Phone: (860) 265-2529
Fax: (860) 463-9562
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 031371 Connecticut

Profile Details

NPI number 1417933961
LBN Legal business name Illescas, Fernando F.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2005
Last updated May 3rd, 2018 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1417933961 NPPES
Connecticut MEDICAID 001313717
Connecticut Other 010031371CT01
Connecticut MEDICAID 1417933961
Connecticut Other A2516306

Popular Providers