NPI 1487847570

Kenneth J. Maiocco, M.D., P.C.

Organisation Dermatology Physician Bridgeport, CT

Practice location

Address: 4639 Main St, Bridgeport, CT 06606-1838
Phone: (203) 374-5546
Fax: (302) 371-4056

Authorised official

Name: David K. Maiocco
Title: Practice Administrator
Phone: (203) 374-5130

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 013652 (CT)

Other Dermatology providers in Connecticut →

Registry record

NPI: 1487847570
Entity type: Organization
NPI issued: 22 Aug 2007
Record last updated: 22 Aug 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.