Individual
DR. JACK ANTHONY PORRINO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510
(203) 688-4242
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
61071
CT
2085R0202X
Diagnostic Radiology Physician
76659
AZ
2085R0202X
Diagnostic Radiology Physician
MD60135255
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487858833
—
WA
Enumeration date
06/11/2007
Last updated
08/20/2018
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