Individual
DAVID LAWRENCE MINGOLELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL EMERGENCY MEDICINE, HARTFORD, CT 06102-5037
(860) 545-0000
Mailing address
PO BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002987
CT
363AM0700X
Medical Physician Assistant
Primary
002987
CT
363AM0700X
Medical Physician Assistant
C0003439
MD
363AS0400X
Surgical Physician Assistant
002987
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003029873
—
CT
Enumeration date
11/17/2006
Last updated
12/20/2013
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