Individual
AIMEE J CRISCUOLO BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
481 GOLD STAR HWY STE 100, GROTON, CT 06340-6702
(860) 446-8858
(860) 405-2140
Mailing address
420 SAYBROOK RD, MIDDLETOWN, CT 06457-4747
(860) 626-2010
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000925
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000925
CONNECTICARE
CT
01
—
290000925CT01
ANTHEM BC/BS
CT
Enumeration date
09/13/2006
Last updated
11/04/2019
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