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General NPI Number Information
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NPI Number | 1467704098
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Entity Type | Organization
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Legal Business Name | PAUL PEZZINO, MD DC OF CT CORP
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 02/07/2019
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Provider Practice Location Address
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Address Line | 330 MAIN ST FL 2
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City | HARTFORD
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State | CT
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Zip | 06106
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Country | US
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Telephone | 203-518-4888
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Fax | 203-518-4889
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Provider Business Mailing Address
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Address Line | 330 MAIN ST FL 2
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City | HARTFORD
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State | CT
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Zip | 06106-1851
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Country | US
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Telephone | 203-518-4888
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Fax | 203-518-4889
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Authorized Official
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Title or Position | M.D.
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Name | DR. PAUL PEZZINO
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Credential |
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Telephone | 718-564-4031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 051098
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License Number State | CT
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