Individual
PETER JOHN FAMIGLIETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
339 FLANDERS RD, SUITE 109, EAST LYME, CT 06333-1700
(860) 739-4811
(860) 739-8151
Mailing address
339 FLANDERS RD, SUITE 109, EAST LYME, CT 06333-1700
(860) 739-4811
(860) 789-8151
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
026252
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010026252CT04
ANTHEM BLUE CROSS
CT
01
—
030671
HEALTH NET
—
01
—
131516
PREFERRED ONE - FIRST CHO
—
01
—
180026127
RAILROAD MEDICARE
CT
01
—
262520
CONNECTICARE
—
01
—
346885100
WORKERS COMP - DEPT OF LA
—
01
—
4618883
AETNA PIN NUMBER
—
01
—
AETNA
AETNA MANAGED CARE
—
01
—
NLS042
OXFORD
—
Enumeration date
07/07/2005
Last updated
12/22/2011
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