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NPI Code Detail

MEDICARE: MARK R. PRETE MD

MEDICARE: MARK R. PRETE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician030593CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1030593OTHERCONNECTICARE

General Provider Information

NPI Number : 1285683953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK R. PRETE MD
Provider Business Mailing Address
First Line : PO BOX 30774
Second Line :
City : HARTFORD
State : CT
Zip : 06150-0774
Country : US
Telephone Number : 866-898-7138
Fax Number : 616-975-9824
Provider Business Practice Location Address
First Line : 540 LITCHFIELD ST
Second Line :
City : TORRINGTON
State : CT
Zip : 06790-6679
Country : US
Telephone Number : 860-496-6435
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 05/02/2008

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