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Individual

DR. MARK GEORGE INDELICATO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
111 FOUNDERS PLZ, SUITE 300, EAST HARTFORD, CT 06108-3212
(860) 282-0833
Mailing address
35 WESTWOOD AVE, DEER PARK, NY 11729-2805
(917) 575-4859

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
044388
CT
207L00000X
Anesthesiology Physician
230300
NY
207LP3000X
Pediatric Anesthesiology Physician
Primary
044388
CT

Other

Enumeration date
04/07/2007
Last updated
08/23/2023
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