Individual
FAUSTO LANAO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1320 W MAIN ST, BUILDING 1, UNIT 1, WATERBURY, CT 06708-3119
(203) 754-3151
(203) 596-7287
Mailing address
133 SCOVILL ST, STE 101, WATERBURY, CT 06706-1127
(203) 709-8873
(203) 709-8689
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
039801
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001398016
—
CT
Enumeration date
05/04/2006
Last updated
07/15/2020
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