NPI 1437359759

Philip a Micalizzi, Jr. M.D. PC

Organisation Preferred Provider Organization Bridgeport, CT

Practice location

Address: 3180 Main St STE 302, Bridgeport, CT 06606-4237
Phone: (203) 372-6505
Fax: (203) 372-5622
Mailing address: 3180 Main Street STE 302, Bridgeport, CT 06606

Authorised official

Name: Philip a Micalizzi
Title: Doctor
Phone: (203) 372-6505

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 026207 (CT)

Other Preferred Provider Organization providers in Connecticut →

Registry record

NPI: 1437359759
Entity type: Organization
NPI issued: 24 Jul 2007
Record last updated: 7 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.