Individual
MARK N FIENGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
196 PARKWAY S, SUITE 103, WATERFORD, CT 06385-1234
(860) 443-4383
(860) 443-3980
Mailing address
164 OTROBANDO AVE, STE B, NORWICH, CT 06360-2116
(860) 443-4383
(860) 443-3980
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
000281
CT
207RI0011X
Interventional Cardiology Physician
00281
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001002815
—
CT
Enumeration date
12/02/2005
Last updated
03/10/2020
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