Anthony D Ciardella M.D. PC

Organization Active NPI Internal Medicine Physician · Southington, CT

NPI 1508065640 · NPPES record last updated Sep 12, 2007

Key facts

NPI
1508065640
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
License
024620 (CT)
Legal business name
ANTHONY D CIARDELLA M.D. PC
Practice address
360-14 N Main St
Southington, CT 06489
Phone
(860) 621-6759
Fax
(860) 621-0117
NPI assigned
Jul 17, 2007
Organization subpart
No

Authorized official

Name
Dr. Anthony D Ciardella, M.D.
Title
President
Phone
(860) 621-6759

National Provider Directory

Locations

360 N Main St
Ste 14
Southington, CT 06489
Phone (860) 378-0165

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X 024620 CT Yes
Primary Care Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LP2300X 34236 CT

Addresses

Primary practice location

360-14 N Main St
Southington, CT 06489

Mailing address

360-14 N Main St
Southington, CT 06489
Phone (860) 621-6759

Other identifiers

IdentifierTypeStateIssuer
C02732OtherCTMEDICARE GROUP #

Other providers in Southington, CT

All providers in Southington, CT · Internal Medicine Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.