Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 014693 | CT |
N | 207RR0500X | Rheumatology | 014693 | CT |
NPI | 1619976917 |
---|---|
Provider Name | Richard Mangi |
First Address | Hamden, CT 06518-3267 |
Second Address | Hamden, CT 06518-3267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 17/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010014693CT01 | BLUE CROSS BLUE SHIELD (01) | CT |
014693 | CONNECTICARE (01) | CT |
0Q2052 | HEALTH NET (01) | CT |
2047700 | AETNA (01) | CT |
440002123 | RAILROAD MEDICARE (01) | CT |
B38588 | (02) | CT |
NHS097 | OXFORD (01) | CT |