Active NPIIndividual provider

Dr. Nicholas Mongillo, MD

Pediatrics, Adolescent Medicine in Shelton, Connecticut

NPI Number1073536710
Practice location
25 Constitution Blvd. So, Shelton, CT 06484-4351
Fax
203-922-0004
Last updated
January 6, 2017

Nicholas Mongillo is a Pediatrics, Adolescent Medicine based in Shelton, CT. Nicholas Mongillo practices in Shelton, CT and has the professional credentials of MD. The NPI Number for Nicholas Mongillo is 1073536710 and holds a License No. 030893 (CT). The current practice location address for Nicholas Mongillo is 25 Constitution Blvd. So, Shelton, CT 06484-4351 and can be reached out via phone at 203-924-7334 and via fax at 203-922-0004.

Provider Profile Details

NPI Number
1073536710
Provider Name
Nicholas Mongillo
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
25 Constitution Blvd. So, Shelton, CT 06484-4351
Phone Number
203-924-7334
Fax Number
203-922-0004
Primary Taxonomy
Pediatrics, Adolescent Medicine · 2080A0000X
Sole Proprietor
No
Provider Enumeration Date
July 25, 2006
Last Update Date
January 6, 2017
NPI Status
Active

Provider Business Practice Location Address Details

Address
25 Constitution Blvd. So
Shelton, CT 06484-4351
Zip
06484-4351
Phone Number
203-924-7334
Fax Number
203-922-0004
Shelton, CT 06484Get directions →

Provider Business Mailing Address Details

Address
25 Constitution Blvd S
Shelton, CT 06484-4351
City
Shelton
State
CT
Zip
06484-4351
Phone Number
203-924-7334
Fax Number
203-922-0004

License Information

License Number
030893
License State
CT
Taxonomy
Pediatrics, Adolescent Medicine · 2080A0000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Dr. Nicholas Mongillo, MD?

The NPI number of Dr. Nicholas Mongillo, MD is 1073536710. It was assigned on July 25, 2006 and is currently active in the NPPES registry.

What is the specialty of Dr. Nicholas Mongillo, MD?

Dr. Nicholas Mongillo, MD is registered under the primary taxonomy Pediatrics, Adolescent Medicine (code 2080A0000X), licensed in CT under license number 030893.

Where does Dr. Nicholas Mongillo, MD practice?

The practice location is 25 Constitution Blvd. So, Shelton, CT 06484-4351. The office can be reached at 203-924-7334 (phone) or 203-922-0004 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1073536710 directly on the NPPES registry website.

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