Individual
DR. MICHAEL NANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MHS
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
333 CEDAR STREET, PO BOX 208017, NEW HAVEN, CT 06520-8017
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
53975
CT
207RC0000X
Cardiovascular Disease Physician
53975
CT
207RI0011X
Interventional Cardiology Physician
Primary
53975
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53975
STATE OF CONNECTICUT MEDICAL LICENSE
CT
Enumeration date
03/21/2012
Last updated
07/27/2021
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