| Anthony D Ciardella M.d. Pc | |
|
360-14 N Main St Southington CT 06489 | |
| (860) 621-6759 | |
| (860) 621-0117 |
| Full Name | Anthony D Ciardella M.d. Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 360-14 N Main St, Southington, Connecticut |
| Authorized Official Name and Position | Anthony D Ciardella (PRESIDENT) |
| Authorized Official Contact | 8606216759 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony D Ciardella M.d. Pc 360-14 N Main St Southington CT 06489 Ph: (860) 621-6759 | Anthony D Ciardella M.d. Pc 360-14 N Main St Southington CT 06489 Ph: (860) 621-6759 |
| NPI Number | 1508065640 |
|---|---|
| Provider Enumeration Date | 07/17/2007 |
| Last Update Date | 09/12/2007 |
| Medicare PECOS PAC ID | 5496742850 |
|---|---|
| Medicare Enrollment ID | O20040513000853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508065640 | NPI | - | NPPES |
| C02732 | Other | CT | MEDICARE GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 024620 (Connecticut) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | 34236 (Connecticut) | Secondary |
| Provider Name | Anthony D Ciardella |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184784126 PECOS PAC ID: 8729075197 Enrollment ID: I20040428000094 |
| Provider Name | Lindsay Mary Searle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215485966 PECOS PAC ID: 7517241730 Enrollment ID: I20170321002082 |
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