Andrew Stephem Miceli

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

21 Grand St
Hartford, CT 06106-1541

Phone

(860) 550-7500

NPI assigned

Sep 9, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1093541013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 DIAMOND TER",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162715",
            "telephone_number": "860-503-9782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GRAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061541",
            "telephone_number": "860-550-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELI",
        "first_name": "ANDREW",
        "middle_name": "STEPHEM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Elizabeth Meyer, PA-C
• Natalie Zakarian Meyers, PA-C
• Paolyne Meza, DO
• Thomas Paul Mezzetti Jr., MD
• Jennifer Miarecki
• Robert G Miceli, MD
• Yvonne Miceli, LMFT
• Zachary J Michaels, MD
• Tomasz G Michalewski, APRN
• Thomas C Michalski Jr., LCSW

• Student in an Organized Health Care Education/Training Program in Hartford, CT
• Providers in Hartford, CT by specialty
• Student in an Organized Health Care Education/Training Program in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.