Individual
RICHARD NICHOLAS FORMICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 HOWARD AVE, YALE PHYSICIANS BUILDING, NEW HAVEN, CT 06519
(203) 785-2140
(203) 785-6414
Mailing address
PO BOX 9805, 300 GEORGE ST 6TH FLOOR, NEW HAVEN, CT 06536-0805
(203) 785-7998
(203) 785-6414
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036848
CT
208M00000X
Hospitalist Physician
036848
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001368481
—
CT
Enumeration date
12/05/2005
Last updated
03/22/2012
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