Individual
RAYMOND JOSEPH IPPOLITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 EAST MAIN STREET, BLDG 2 UNIT 5, BRANFORD, CT 06405
(203) 481-6722
(203) 483-2074
Mailing address
420 EAST MAIN STREET, BLDG 2 UNIT 5, BRANFORD, CT 06405
(203) 481-6722
(203) 483-2074
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
016865
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010016865CT01
BCBS
—
01
—
0Q1189
HEALTHNET
—
01
—
709727
CONNECTICARE
—
Enumeration date
09/20/2006
Last updated
01/11/2012
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