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Individual

DR. PHILIP R. CORVO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1253
(203) 709-6000
Mailing address
56 FRANKLIN ST, WATERBURY, CT 06706-1253
(203) 709-6000

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
036513
CT
208600000X
Surgery Physician
036513
CT
2086S0102X
Surgical Critical Care Physician
Primary
036513
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001365130
CT
01
1190689
USA
CT
01
5265654
AETNA
CT
01
PENDING
RAILROAD MEDICARE
CT
Enumeration date
09/28/2006
Last updated
05/11/2022
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