Individual
AMY CIMMINELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
495 HAWLEY LN STE 2A, STRATFORD, CT 06614-1597
(203) 375-2861
(203) 502-2615
Mailing address
6 RESEARCH DR STE 105, SHELTON, CT 06484-6228
(203) 210-6340
(203) 502-2615
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001330
CT
363AS0400X
Surgical Physician Assistant
001330
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004053310
—
CT
Enumeration date
11/30/2011
Last updated
06/13/2023
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