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Organization

FEDERAL HILL SURGICAL GROUP, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OVLETO W. CICCARELLI MD (PRESIDENT)
(860) 583-1845
Entity
Organization

Contact information

Practice address
291 QUEEN ST, BRISTOL, CT 06010-6379
(860) 583-1845
Mailing address
291 QUEEN ST, BRISTOL, CT 06010-6379
(860) 583-1845

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
026950
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00126950600
BLUE CARE FAMILY
CT
01
707249
AETNA-US HEALTH
CT
01
755038
CONNECTICARE
CT
01
HAS048
OXFORD
CO
01
OR2818
HEALTHNET
CT
Enumeration date
06/26/2006
Last updated
08/22/2020
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