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General NPI Number Information
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NPI Number | 1114929379
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Entity Type | Organization
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Legal Business Name | SCOVILL MEDICAL GROUP, PC
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 12/17/2007
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Provider Practice Location Address
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Address Line | 56 FRANKLIN ST
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City | WATERBURY
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State | CT
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Zip | 06706-1221
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Country | US
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Telephone | 203-709-8888
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Fax | 203-709-8689
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Provider Business Mailing Address
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Address Line | 56 FRANKLIN ST FL 3
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City | WATERBURY
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State | CT
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Zip | 06706-1221
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Country | US
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Telephone | 203-709-8873
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Fax | 203-709-8689
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FRANCO GALASSO
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Credential | MD
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Telephone | 203-597-9410
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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 |
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License Number State |
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