Dr. Nicholas Mongillo
Adolescent Medicine
25 Constitution Blvd. So
Shelton
, Connecticut 06484-4351
Dr. Nicholas Mongillo
Adolescent Medicine
25 Constitution Blvd. So
Shelton
, Connecticut 06484-4351
(203) 922-0004
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Dr. Nicholas Mongillo
- 25 Constitution Blvd S
- Shelton, CT
- Zip : 06484-4351
- Fax : (203) 922-0004
- Phone : (203) 924-7334
Second Address
- Dr. Nicholas Mongillo
- 25 Constitution Blvd. So
- Shelton, CT
- Zip : 06484-4351
- Fax : (203) 922-0004
- Phone : (203) 924-7334
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | 030893 | CT |
National Provider Identifier
| NPI | 1073536710 |
|---|---|
| Provider Name | Dr. Nicholas Mongillo |
| First Address | Shelton, CT 06484-4351 |
| Second Address | Shelton, CT 06484-4351 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/07/2006 |
| Last Update Date | 06/01/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.