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General NPI Number Information
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NPI Number | 1366444135
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Entity Type | Individual
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Provider Name | MARC A CIAMPI M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 140 GRANDVIEW AVE SUITE 104
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City | WATERBURY
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State | CT
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Zip | 06708-2505
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Country | US
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Telephone | 203-597-9733
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Fax | 203-597-9732
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Provider Business Mailing Address
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Address Line | 140 GRANDVIEW AVE SUITE 104
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City | WATERBURY
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State | CT
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Zip | 06708-2505
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Country | US
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Telephone | 203-597-9733
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Fax | 203-597-9732
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 037620
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License Number State | CT
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