Mongillo, Anthony
Mongillo, Anthony is an individual health care provider with primary practice located at 3180 Main St Suite 301, Bridgeport CT 06606-4237. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Mongillo, Anthony can be contacted via phone (203) 373-9100.Contact Information
Primary practice address
3180 Main St Suite 301
Bridgeport CT 06606-4237
Phone: (203) 373-9100
Fax: (203) 365-8492
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 023825 | Connecticut |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 023825 | Connecticut |
Profile Details
| NPI number | 1558324228 |
|---|---|
| LBN Legal business name | Mongillo, Anthony |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2006 |
| Last updated | May 31st, 2013 - about 11 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 | 1558324228 | NPPES |
| Connecticut | MEDICAID | 001238252 |
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