Individual provider · Type 1 NPI
John Antonucci
Addiction Medicine (Psychiatry & Neurology) Physician · Newington, CT
Practice location
555 Willard Ave
Newington, CT 06111-2631
Mailing address
11 Woodchuck Hill Rd
Canton, CT 06019-2132
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician Primary | 2084A0401X | 09502 (CT) |
Addiction Medicine (Psychiatry & Neurology) Physician: A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
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About NPI 1508967951
John Antonucci's National Provider Identifier is 1508967951, issued on Sep 26, 2006. The primary taxonomy on file is Addiction Medicine (Psychiatry & Neurology) Physician (2084A0401X), and the practice location is in Newington, CT. The record was last updated on Jul 8, 2007.