MEDICARE: THOMAS E VERDONE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	031489	CT
2	207L00000X	Anesthesiology Physician	031489	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982692794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS E VERDONE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 417297
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-7297
Country	:	US
Telephone Number	:	866-623-3869
Fax Number	:	302-709-2402

Provider Business Practice Location Address
First Line	:	111 GOOSE LN
Second Line	:
City	:	GUILFORD
State	:	CT
Zip	:	06437-5101
Country	:	US
Telephone Number	:	203-453-7100
Fax Number	:	203-453-7810

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	06/19/2015

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Directions to “ THOMAS E VERDONE M.D.” Practice Location

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