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Individual

MRS. AMANDA MARIA DELCAVO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
50 FRANKLIN STREET, WATERBURY, CT 06706
(203) 709-6000
Mailing address
50 FRANKLIN STREET, WATERBURY, CT 06706
(203) 709-6000

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002616
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008036975
CT
01
1158906
USA
CT
01
26160
CONNECTICARE
CT
01
642587
WELLCARE
CT
01
9840786
AETNA
CT
01
P01268782
RR MEDICARE
CT
01
P4447933
OXFORD
CT
Enumeration date
10/17/2011
Last updated
11/09/2021
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