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General NPI Number Information
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NPI Number | 1093110462
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Entity Type | Organization
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Legal Business Name | LIVELLA CARE, LLC
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 4 BRUSHY PLAIN RD SUITE 519
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City | BRANFORD
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State | CT
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Zip | 06405-6000
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Country | US
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Telephone | 203-214-4527
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Fax |
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Provider Business Mailing Address
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Address Line | 4 BRUSHY PLAIN RD SUITE 519
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City | BRANFORD
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State | CT
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Zip | 06405-6000
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Country | US
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Telephone | 203-214-4527
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN, OWNER
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Name | DR. ANTONIO D'ARIA
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Credential | D.O.
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Telephone | 203-214-4527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 045151
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License Number State | CT
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