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General NPI Number Information
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NPI Number | 1902481930
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Entity Type | Organization
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Legal Business Name | CARE BEYOND MEDICINE PLLC
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 2247 E MAIN ST SUITE 103
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City | WATERBURY
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State | CT
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Zip | 06705
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Country | US
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Telephone | 203-527-7269
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Fax | 203-987-3220
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Provider Business Mailing Address
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Address Line | 2247 E MAIN ST SUITE 103
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City | WATERBURY
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State | CT
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Zip | 06705
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Country | US
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Telephone | 203-527-7269
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Fax | 203-987-3220
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Authorized Official
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Title or Position | MD/OWNER
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Name | PHILIP MONGELLUZZO
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Credential |
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Telephone | 203-527-7269
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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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