Individual
ANDREW STEPHEM MICELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
Mailing address
4 DIAMOND TER, WOLCOTT, CT 06716-2715
(860) 503-9782
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CT
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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