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NPI Code Detail

MEDICARE: DR. RAYMOND L D'AMATO M.D.

MEDICARE:  DR. RAYMOND L D'AMATO  M.D.
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
1207R00000XInternal Medicine Physician017716CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101217716OTHERCTCIGNA ID
2060916784009OTHERCTTRICARE HNFS ID
3P369835OTHERCTOXFORD PROVIDER ID
4060078OTHERCTHEALTH NET ID
5010017716CT02OTHERCTBCBS COMMERCIAL N BCFP ID
6050843OTHERCTCONNECTICARE ID
71255448155OTHERCTGHMC GRP NPI ID
8501435OTHERCTAETNA PROVIDER ID
9912611OTHERCTHEALTH NET REFERRAL ID

General Provider Information

NPI Number : 1477555787
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYMOND L D'AMATO M.D.
Provider Business Mailing Address
First Line : 300 KENSINGTON AVE
Second Line :
City : NEW BRITAIN
State : CT
Zip : 06051-3916
Country : US
Telephone Number : 860-224-6200
Fax Number : 860-224-6260
Provider Business Practice Location Address
First Line : 136 BERLIN RD
Second Line : SUITE 102
City : CROMWELL
State : CT
Zip : 06416-2627
Country : US
Telephone Number : 860-635-2810
Fax Number : 860-632-2352
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 07/09/2007

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