| 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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