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VICTOR EANNIELLO MD

>> Specialist >> Other Service Providers

Registrant NPI Number: 1174577688

Individual Registrant:
 VICTOR  EANNIELLO MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
201 CHESTNUT HILL RD  STAFFORD SPRINGS, CT 06076-9925 US
Tel: 860-684-8424  Fax: 860-684-8460

Contact information for business:
99 EAST RIVER DRIVE  EAST HARTFORD, CT 06108 US
Tel: 860-684-8424  Fax: 860-684-8460

Registration Information:
NPI: 1174577688
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N174400000XOther Service Providers
Specialist
CT031823
Y207L00000XAllopathic & Osteopathic Physicians
Anesthesiology
CT31823

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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