Individual
DR. SERGIO R CASILLAS-ROMERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
12 CASE ST, SUITE 313, NORWICH, CT 06360-2222
(860) 204-9126
(860) 204-9146
Mailing address
112 LAFAYETTE STREET, NORWICH, CT 06360
(860) 425-8735
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
41831
CT
208C00000X
Colon & Rectal Surgery Physician
Primary
41831
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010041831CT02
ANTHEM
CT
05
—
1417035338
—
CT
01
—
3V1171
HEALTHNET
CT
Enumeration date
11/01/2006
Last updated
10/30/2015
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