Healthcare Provider Details

I. General information

NPI: 1184641995
Provider Name (Legal Business Name): RHONDA FELICIA-ANN CERRITELLI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 07/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 BREWSTER RD
BRISTOL CT
06010-5161
US

IV. Provider business mailing address

PO BOX 2828
BRISTOL CT
06011-2828
US

V. Phone/Fax

Practice location:
  • Phone: 860-585-3000
  • Fax: 860-585-3907
Mailing address:
  • Phone: 860-585-3858
  • Fax: 860-585-3907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number000929
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: