Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 9823 | CT |
NPI | 1548846769 |
---|---|
Provider Name | Anthony Vincent Santangelo |
First Address | New Britain, CT 06052-2016 |
Second Address | New Britain, CT 06052-2016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2021 |
Last Update Date | 29/07/2021 |