Individual
SALVATORE IACOBELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 RETREAT AVENUE, HARTFORD HOSPITAL PSYCHIATRY DEPT, HARTFORD, CT 06106-3310
(860) 545-5000
Mailing address
PO BOX 41933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
038243
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1382431CL
CLINIC
—
05
—
4014679
—
CT
05
—
4024972
—
CT
Enumeration date
10/13/2006
Last updated
09/02/2010
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