Healthcare Provider Details

I. General information

NPI: 1568487643
Provider Name (Legal Business Name): PETER D. SCHIOPPO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 ORANGE ST
NEW HAVEN CT
06511-3824
US

IV. Provider business mailing address

633 ORANGE ST
NEW HAVEN CT
06511-3824
US

V. Phone/Fax

Practice location:
  • Phone: 203-562-4051
  • Fax: 203-865-7567
Mailing address:
  • Phone: 203-562-4051
  • Fax: 203-865-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number485
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: