Individual
DR. GREGORY GERARD DECANDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1461 SOUTH BRITAIN ROAD, SOUTHBURY, CT 06488-0901
(203) 586-2000
Mailing address
1461 SOUTH BRITAIN ROAD/ P.O. BOX 872, SOUTHBURY, CT 06488-0901
(203) 586-2000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
029717
CT
207Q00000X
Family Medicine Physician
76773
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3128075
—
MA
Enumeration date
12/06/2005
Last updated
03/27/2014
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