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General NPI Number Information
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NPI Number | 1598795205
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Entity Type | Organization
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Legal Business Name | FPIM OF NEW HAVEN COUNTY,LLC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 205 MAIN ST
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City | EAST HAVEN
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State | CT
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Zip | 06512-3003
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Country | US
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Telephone | 203-466-5070
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Fax | 203-466-5075
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Provider Business Mailing Address
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Address Line | 205 MAIN ST
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City | EAST HAVEN
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State | CT
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Zip | 06512-3003
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Country | US
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Telephone | 203-466-5070
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Fax | 203-466-5075
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANGELO ACCOMANDO
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Credential | M.D.
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Telephone | 203-466-5070
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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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