Individual
MR. DOMINICK C. MARICONDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
20 YORK ST, CB 2045, NEW HAVEN, CT 06504-8900
(203) 688-8993
Mailing address
11 E GATE RD, GUILFORD, CT 06437-2263
(203) 458-1634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000794
CT
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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