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Individual

DAVID E. CIANCIMINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4697 MAIN ST, BRIDGEPORT, CT 06606-1869
(203) 372-5695
(203) 459-0574
Mailing address
4697 MAIN ST, BRIDGEPORT, CT 06606-1869
(203) 372-5695
(203) 459-0574

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
031679
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010031679CT01
BLUE CROSS
CT
01
134581
CIGNA
CT
01
168586
MANAGED HEALTH NETWORK
CT
01
ZS814
OXFORD
CT
Enumeration date
07/17/2006
Last updated
07/08/2007
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