Italia, Gary R

Italia, Gary R is an individual health care provider with primary practice located at 368 Franklin Ave , Hartford CT 06114. He recently has 3 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Dietary & Nutritional Service Providers / Nutritionist, Dietary & Nutritional Service Providers / Dietitian, Registered. Chiropractic Providers / Chiropractor is his primary health care specialty. Italia, Gary R can be contacted via phone (860) 296-4411.

Contact Information

Primary practice address
368 Franklin Ave Hartford CT 06114
Phone: (860) 296-4411
Fax: (860) 296-9995
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 760 Connecticut
Dietary & Nutritional Service Providers / Nutritionist 133N00000X 451 Connecticut
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 451 Connecticut

Profile Details

NPI number 1104929702
LBN Legal business name Italia, Gary R
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2006
Last updated Apr 16th, 2013 - about 12 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 1104929702 NPPES
Connecticut MEDICAID 004089571

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