Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 006652 | CT |
NPI | 1043344641 |
---|---|
Provider Name | Dr. Richard F Amato |
First Address | Monroe, CT 06468-2280 |
Second Address | Monroe, CT 06468-2280 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |