Organization
KENNETH F. MARICI, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH F MARICI M.D. (PRESIDENT)
(860) 354-5511
Entity
Organization
Contact information
Practice address
2 OLD PARK LANE RD STE 1, NEW MILFORD, CT 06776-2561
(860) 354-5511
(860) 350-3122
Mailing address
2 OLD PARK LANE RD STE 1, NEW MILFORD, CT 06776-2561
(860) 354-5511
(860) 350-3122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036520
CT
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
001512
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001365205
—
CT
Enumeration date
12/04/2007
Last updated
08/14/2024
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