Individual
JOSHUA SAN VICENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-5322
(860) 358-6298
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-5322
(860) 358-6298
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036371
CT
208M00000X
Hospitalist Physician
036371
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036371
CT LICENSE
CT
Enumeration date
02/23/2006
Last updated
03/03/2014
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