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General NPI Number Information
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NPI Number | 1336155860
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Entity Type | Individual
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Provider Name | ANTHONY CHIEFFALO M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 03/14/2011
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Provider Practice Location Address
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Address Line | 168 RTE. 171
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City | S WOODSTOCK
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State | CT
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Zip | 06267-0366
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Country | US
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Telephone | 860-928-7775
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Fax | 860-928-1397
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Provider Business Mailing Address
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Address Line | PO BOX 366
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City | S WOODSTOCK
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State | CT
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Zip | 06267-0366
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Country | US
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Telephone | 860-928-7775
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Fax | 860-928-1397
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 028895
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License Number State | CT
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