person
Vincent J Miccoli, PA
Surgical Physician Assistant in Torrington, Connecticut
NPI 1811949571

Vincent J Miccoli is a Surgical Physician Assistant based in Torrington, CT and is specialized in Surgical. Vincent J Miccoli practices in Torrington, CT and has the professional credentials of PA. The NPI Number for Vincent J Miccoli is 1811949571 and holds a License No. 000949 (Connecticut).

The current practice location address for Vincent J Miccoli is 245 Alvord Park Road, Torrington, CT and can be reached out via phone at 860-482-8539 and via fax at 860-482-0258. You can also correspond with Vincent J Miccoli through the mailing address at 245 ALVORD PARK ROAD, TORRINGTON, CT - 06790 (mailing address contact number: 860-482-8539).

Location: 245 Alvord Park Road, Torrington, CT, 06790
person
Provider Profile Details
NPI Number
1811949571
Provider Name
Vincent J Miccoli
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
245 Alvord Park Road, Torrington, CT, 06790
Phone Number
860-482-8539
Fax Number
860-482-0258
Provider Enumeration Date
05/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
290000949CT01 01 CT BC
000949 01 CT CONNECTICARE
institution
Provider Business Practice Location Address Details
Address
245 Alvord Park Road
City
State
Zip
06790
Phone Number
860-482-8539
Fax Number
860-482-0258
person
Provider Business Mailing Address Details
Address
245 Alvord Park Road
City
State
Zip
06790
Phone Number
860-482-8539
Fax Number
860-482-0258
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
000949 (Connecticut)
Definition
Definition to come...
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