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General NPI Number Information
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NPI Number | 1982637823
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Entity Type | Organization
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Legal Business Name | MARK A. PERROTTI,M.D.LLC
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 251 W MAIN ST
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City | BRANFORD
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State | CT
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Zip | 06405-4047
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Country | US
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Telephone | 203-481-0077
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Fax |
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Provider Business Mailing Address
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Address Line | 251 W MAIN ST
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City | BRANFORD
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State | CT
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Zip | 06405-4047
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Country | US
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Telephone | 203-481-0077
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK ANTHONY PERROTTI
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Credential | MD
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Telephone | 203-481-0077
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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 | 037644
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License Number State | CT
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