| Diana Digiacomo-canellas,llc | |
|
705 N Mountain Rd Suite 110 Newington CT 06111-1412 | |
| (860) 324-6841 | |
| Not Available |
| Full Name | Diana Digiacomo-canellas,llc |
|---|---|
| Speciality | Social Worker |
| Location | 705 N Mountain Rd, Newington, Connecticut |
| Authorized Official Name and Position | Diana Silvia Digiacomo-canellas (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8603246841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diana Digiacomo-canellas,llc 6 Freeman St Hartford CT 06114-2719 Ph: (860) 324-6841 | Diana Digiacomo-canellas,llc 705 N Mountain Rd Suite 110 Newington CT 06111-1412 Ph: (860) 324-6841 |
| NPI Number | 1215252614 |
|---|---|
| Provider Enumeration Date | 03/30/2010 |
| Last Update Date | 03/30/2010 |
| Medicare PECOS PAC ID | 8022202258 |
|---|---|
| Medicare Enrollment ID | O20101102000682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215252614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 006422 (Connecticut) | Primary |
| Provider Name | Diana Digiacomo-canellas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215060892 PECOS PAC ID: 0042306706 Enrollment ID: I20071011000387 |
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