Immordino, Peter Anthony

Immordino, Peter Anthony is an individual health care provider with primary practice located at 263 Farmington Ave , Farmington CT 06030-5386. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Immordino, Peter Anthony can be contacted via phone (860) 679-5500.

Contact Information

Primary practice address
263 Farmington Ave Farmington CT 06030-5386
Phone: (860) 679-5500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 115497 Connecticut

Profile Details

NPI number 1306153580
LBN Legal business name Immordino, Peter Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2010
Last updated Sep 8th, 2010 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306153580 NPPES
Connecticut MEDICAID 001154970

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