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Organization

KENNETH J. MAIOCCO, M.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID K. MAIOCCO (PRACTICE ADMINISTRATOR)
(203) 374-5130
Entity
Organization

Contact information

Practice address
4639 MAIN ST, BRIDGEPORT, CT 06606-1838
(203) 374-5546
(302) 371-4056
Mailing address
4639 MAIN ST, BRIDGEPORT, CT 06606-1838
(203) 374-5546
(302) 371-4056

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
013652
CT

Other

Enumeration date
08/22/2007
Last updated
08/22/2007
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