Individual
ANTONIO SANTORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
BRISTOL HOSPITAL, BREWSTER RD., BRISTOL, CT 06011-0977
(860) 585-3528
Mailing address
244 COPPERMILL RD, WETHERSFIELD, CT 06109-4013
(860) 563-0115
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000088
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290000088CT01
ANTHEM BC & BS
—
Enumeration date
07/08/2006
Last updated
07/08/2007
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