Individual
GERALD MICALIZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
558 FAIRVIEW AVE, BRIDGEPORT, CT 06606-4501
(203) 260-2493
Mailing address
558 FAIRVIEW AVE, BRIDGEPORT, CT 06606-4501
(203) 260-2493
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
037528
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001375288
—
CT
Enumeration date
09/20/2005
Last updated
05/14/2014
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