Healthcare Provider Details

I. General information

NPI: 1629239454
Provider Name (Legal Business Name): MASSIMO VERARDO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 STRAITS TPKE STE E
MIDDLEBURY CT
06762-2800
US

IV. Provider business mailing address

900 STRAITS TPKE STE E
MIDDLEBURY CT
06762-2800
US

V. Phone/Fax

Practice location:
  • Phone: 203-577-2095
  • Fax: 203-577-2098
Mailing address:
  • Phone: 203-577-2095
  • Fax: 203-577-2098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number001770
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: