Healthcare Provider Details

I. General information

NPI: 1235289398
Provider Name (Legal Business Name): ANGELO HUMBERTO PAREDES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 SAYBROOK RD STE 201
MIDDLETOWN CT
06457-4777
US

IV. Provider business mailing address

410 SAYBROOK RD STE 201
MIDDLETOWN CT
06457-4777
US

V. Phone/Fax

Practice location:
  • Phone: 860-347-4620
  • Fax: 860-346-9687
Mailing address:
  • Phone: 860-347-4620
  • Fax: 860-346-9687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1111111
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number0101242769
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number66403
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: