Carlo Antonino, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

000799CT01 Issued in CT

Practice address

259 S Broad St
Pawcatuck, CT 06379-1402

Phone

(860) 599-5551

Fax

(860) 599-5595

NPI assigned

Jan 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Other names 1

• Dr. Carlo Antonino Professional name

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154488815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 S BROAD ST",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791402",
            "telephone_number": "860-599-5551",
            "fax_number": "860-599-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 S BROAD ST",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791402",
            "telephone_number": "860-599-5551",
            "fax_number": "860-599-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONINO",
        "first_name": "CARLO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "000799CT01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLO",
            "last_name": "ANTONINO",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Sarah E Bicknell, P.T.
• Vera Marie Borkowski, MS, FNP-C

• Chiropractor in Pawcatuck, CT
• Providers in Pawcatuck, CT by specialty
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.