Individual
JOHN ANTONUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
555 WILLARD AVE, NEWINGTON, CT 06111-2631
(860) 677-6747
Mailing address
11 WOODCHUCK HILL RD, CANTON, CT 06019-2132
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
09502
CT
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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