Individual
FAUSTO PETRUZZIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
52 WASHINGTON AVE, SUITE 4, NORTH HAVEN, CT 06473-1724
(203) 672-2800
(203) 672-2801
Mailing address
52 WASHINGTON AVE, SUITE 4, NORTH HAVEN, CT 06473-1724
(203) 672-2800
(203) 672-2801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036943
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001369439
—
CT
01
—
010036943CT01
ANTHEM BCBS
CT
01
—
010036943CT07
ANTHEM BCBS
CT
01
—
2V9255
HEALTHNET
CT
01
—
5941638
AETNA
CT
01
—
754451
CONNECTICARE
CT
01
—
754451Q040
CONNECTICARE
CT
01
—
P00441640
RAILROADMEDICARE
CT
01
—
P3846616
OXFORD HEALTH PLAN
CT
Enumeration date
09/23/2005
Last updated
07/22/2016
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