Individual
MICHAEL DIBIANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 RETREAT AVE, HARTFORD HOSPITAL PSYCH DEPT, HARTFORD, CT 06106-3309
(860) 972-7909
Mailing address
200 RETREAT AVE, HARTFORD HOSPITAL PSYCH DEPT, HARTFORD, CT 06106-3309
(860) 972-7909
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
61967
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/24/2016
Last updated
10/29/2018
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