Organization
MANCHESTER MEDICAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA M CAPUTO MD (PRESIDENT)
(860) 646-6210
Entity
Organization
Contact information
Practice address
130 HARTFORD RD, MANCHESTER, CT 06040-5921
(860) 646-6210
(860) 645-3363
Mailing address
130 HARTFORD RD, MANCHESTER, CT 06040-5921
(860) 646-6210
(860) 645-3363
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4129749
—
CT
01
—
C003687
CHAMPUS
CT
Enumeration date
03/14/2006
Last updated
12/26/2007
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