Dr. Philip A. Mongelluzzo, Jr. Llc | |
2247 East Main Street Waterbury CT 06705 | |
(203) 757-3486 | |
(203) 757-4376 |
Full Name | Dr. Philip A. Mongelluzzo, Jr. Llc |
---|---|
Speciality | Internal Medicine |
Location | 2247 East Main Street, Waterbury, Connecticut |
Authorized Official Name and Position | Philip A. Mongelluzzo (OWNER) |
Authorized Official Contact | 2037573486 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Dr. Philip A. Mongelluzzo, Jr. Llc 93 Hempel Drive Wolcott CT 06716 Ph: (203) 757-3486 | Dr. Philip A. Mongelluzzo, Jr. Llc 2247 East Main Street Waterbury CT 06705 Ph: (203) 757-3486 |
NPI Number | 1275627093 |
---|---|
Provider Enumeration Date | 10/03/2006 |
Last Update Date | 06/13/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275627093 | NPI | - | NPPES |
004245272 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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