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General NPI Number Information
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NPI Number | 1922286541
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Entity Type | Organization
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Legal Business Name | RHEUMATOLOGY AND INTERNAL MEDICINE ASSOC LLC
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 3180 MAIN ST SUITE 204
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4237
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Country | US
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Telephone | 203-371-6969
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Fax | 203-371-2980
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Provider Business Mailing Address
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Address Line | 3180 MAIN ST SUITE 204
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4237
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Country | US
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Telephone | 203-371-6969
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Fax | 203-371-2980
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Authorized Official
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Title or Position | SENIOR PARTNER
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Name | DR. GERMANO GUADAGNOLI
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Credential | MD
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Telephone | 203-371-6969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 030610
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License Number State | CT
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