Individual
PETER FRANCIS DADDARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 NEWELL RD STE D21, BRISTOL, CT 06010
(860) 585-6944
(860) 585-7746
Mailing address
25 NEWELL RD STE D21, BRISTOL, CT 06010-5128
(860) 585-6944
(860) 585-7746
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
029024
CT
208800000X
Urology Physician
CT029024
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010029024CT03
ANTHEM BLUE CROSS
—
Enumeration date
11/03/2006
Last updated
11/09/2018
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