Individual
MR. PHILIP A. MONGELLUZZO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2247 EAST MAIN STREET, SUITE 103, WATERBURY, CT 06705
(203) 757-3486
(203) 757-3723
Mailing address
2247 EAST MAIN STREET, SUITE 103, WATERBURY, CT 06705
(203) 757-3486
(203) 757-3723
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
038887
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001388877
—
CT
05
—
004245272
—
CT
Enumeration date
01/26/2006
Last updated
06/17/2021
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