Mongelluzzo, Philip A.

Mongelluzzo, Philip A. is an sole proprietor health care provider with primary practice located at 2247 East Main Street Suite 103, Waterbury CT 06705. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mongelluzzo, Philip A. can be contacted via phone (203) 757-3486.

Contact Information

Primary practice address
2247 East Main Street Suite 103 Waterbury CT 06705
Phone: (203) 757-3486
Fax: (203) 757-3723
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 038887 Connecticut

Profile Details

NPI number 1871563247
LBN Legal business name Mongelluzzo, Philip A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2006
Last updated Jun 17th, 2021 - about 3 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 1871563247 NPPES
Connecticut MEDICAID 001388877
Connecticut MEDICAID 004245272

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