Individual
DR. DOMENICK JOHN MASIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
430 OLD SIB RD, RIDGEFIELD, CT 06877-2335
(203) 826-3582
(855) 798-2816
Mailing address
430 OLD SIB RD, RIDGEFIELD, CT 06877-2335
(212) 688-4818
(855) 798-2816
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
000278
CT
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
167000
NY
207Q00000X
Family Medicine Physician
000278
CT
207Q00000X
Family Medicine Physician
167000
NY
Other
Enumeration date
04/10/2007
Last updated
09/13/2016
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