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MARK GERARD AMIRAULT DO, MPH

>> Organized Health Care Education/Training Program >> Student

Registrant NPI Number: 1356802441

Individual Registrant:
 MARK GERARD AMIRAULT DO, MPH
Gender: M
Not Sole Proprietor

Location and contact information for practice:
71 HAYNES ST  MANCHESTER, CT 06040-4131 US
Tel: 860-533-4679  Fax: --

Contact information for business:
33 GOSLEE DR APT 33  MANCHESTER, CT 06040-5843 US
Tel: --  Fax: --

Registration Information:
NPI: 1356802441
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y390200000XStudent
Organized Health Care Education/Training Program

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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