Individual
ANTHONY JOSEPH VANNUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5011
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 936-3300
(803) 936-7735
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
4358
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3955
CT STATE LICENSE
CT
Enumeration date
08/02/2017
Last updated
04/20/2023
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