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Organization

PRIMARY CARE OF MYSTIC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LOUIS C IOVINO D.O. (OWNER / PHYSICIAN)
(757) 753-0010
Entity
Organization

Contact information

Practice address
41 E MAIN ST, MYSTIC, CT 06355-2831
(860) 572-2988
Mailing address
41 E MAIN ST, MYSTIC, CT 06355-2831
(860) 572-2988

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
046497
CT
207R00000X
Internal Medicine Physician
046497
CT
207R00000X
Internal Medicine Physician
Primary
047587
CT
207R00000X
Internal Medicine Physician
DO00649
RI

Other

Enumeration date
07/18/2009
Last updated
02/16/2010
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