Micheal W Acocella, B.S., P.T.
Individual provider Active NPI Specialist · Greenwich, CT
NPI 1992768303 · NPPES record last updated May 18, 2010
Key facts
- NPI
- 1992768303
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 004700 (CT)
- Practice address
- 469 W Putnam Ave
Suite 202
Greenwich, CT 06830-6060 - Phone
- (203) 869-5546
- Fax
- (203) 629-4836
- NPI assigned
- Apr 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4700 | CT | MD | Registered Nurse |
| 004700 | CT | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 004700 | CT | Yes |
Addresses
Primary practice location
469 W Putnam Ave
Suite 202
Greenwich, CT 06830-6060
Mailing address
469 W Putnam Ave
Suite 202
Greenwich, CT 06830-6060
Phone (203) 869-5546
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4305214 | Other | CT | AETNA |
| 397526 | Other | CT | PHCS |
Other providers in Greenwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.