VINCENT J MICCOLI (NPI# 1811949571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811949571 |
| Entity Type | Individual |
| Full Name | VINCENT J MICCOLI |
| Credential | PA |
| Practice Address |
245 Alvord Park Road Torrington CT 06790 |
| Practice Telephone | 8604828539 |
| Practice Fax Number | 8604820258 |
| Mailing Telephone | 8604828539 |
| Mailing Fax Number | 8604820258 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2014-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
000949 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | CONNECTICARE | 000949 | 01 |
| CT | BC | 290000949CT01 | 01 |
| Street Address |
245 ALVORD PARK ROAD |
| City | TORRINGTON |
| State | CT |
| Zip Code | 06790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073578050 | Steven R Mccoy | Orthopaedic Surgery | 245 Alvord Park Road, Torrington, CT 06790 | 2006-04-20 |
| 1831374016 | Brian M Mccauley | Physical Therapist | 245 Alvord Park Road, Suite 2, Torrington, CT 06790-3493 | 2008-01-07 |
| 1619986627 | Robert G Ross | Physical Therapist | 245 Alvord Park Road, Suite 2, Torrington, CT 06790-3493 | 2006-08-07 |
| 1013925742 | Melissa S Picard | Occupational Therapist | 245 Alvord Park Road, Suite 2, Torrington, CT 06790-3493 | 2006-08-05 |
| 1003824707 | Richard B Boulli Jr. | Physical Therapist | 245 Alvord Park Road, Suite 2, Torrington, CT 06790-3493 | 2006-08-04 |
| 1285642900 | Laura M Nietch | Physical Therapist | 245 Alvord Park Road, Suite 2, Torrington, CT 06790-3493 | 2006-08-04 |
| 1780612739 | Jennifer L Ley | Occupational Therapist | 245 Alvord Park Road, Torrington, CT 06790 | 2006-06-29 |
| 1205877230 | Sandra J Szymanski | Physical Therapist | 245 Alvord Park Road, Torrington, CT 06790 | 2006-06-09 |
| 1134173693 | Kathleen M Sileo | Physical Therapist | 245 Alvord Park Road, Torrington, CT 06790 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606516 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 1280 East Main Street, Torrington, CT 06790 | 2020-10-15 |
| 1477118214 | Heller Counseling Services LLC | Counselor | 100 Migeon Ave., Torrington, CT 06790 | 2019-05-07 |
| 1760964704 | Sheethal Joseph Mathew | Dental Hygienist | 49 South Main Street, Torrington, CT 06790 | 2018-09-06 |
| 1134607708 | Julia Baiju | Physical Therapist | 245 Alvord Park Rd Ste A2, Torrington, CT 06790 | 2018-08-05 |
| 1982194585 | Wellness At Home, LLC | Social Worker | 254 Eno Ave, Torrington, CT 06790 | 2018-05-18 |
| 1285142646 | A Step Up Counseling LLC | Counselor | 185 E Elm St, #2057, Torrington, CT 06790 | 2018-01-18 |
| 1093232597 | Joongwan Jay Kim | Pharmacist | 28 E Elm Street, Torrington, CT 06790 | 2017-08-25 |
| 1861869018 | Breanna M Berg | Physical Therapist | 30 Peck Road, Building #1; Suite 1101, Torrington, CT 06790 | 2015-08-24 |
| 1831570803 | Valerie Lange | Counselor | 326 Albany Turnpike, Canton, CT 06790 | 2015-06-15 |
| 1992120646 | Fitness Pantheon, LLC | Clinic/Center | 221 Water Street, Torrington, CT 06790 | 2014-03-04 |
| Find all providers in zip 06790 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609147826 | Kristen E Darson | Physician Assistant | 245 Alvord Park Rd, Torrington, CT 06790-3493 | 2012-01-19 |
| 1497086854 | Kimberly A Sweezy | Physician Assistant | 245 Alvord Park Rd, Torrington, CT 06790-3493 | 2010-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798362 | Brandon H Kusako | Physician Assistant | 34 Maple St Dept Of, Norwalk, CT 06850-3815 | 2020-10-26 |
| 1073137097 | Page Renee Burns | Physician Assistant | 40 Bertrose Ave, Milford, CT 06460-5906 | 2020-06-05 |
| 1043848575 | Caitlin Ann Kimberly | Physician Assistant | 40 Avalon Dr Unit 6331, Milford, CT 06460-8956 | 2020-03-30 |
| 1699307199 | Lindy Carelli | Physician Assistant | 330 Washington St Ste 410, Norwich, CT 06360-2700 | 2020-02-12 |
| 1174166722 | Jacqueline Clarizio | Physician Assistant | 5520 Park Ave Ste 300, Trumbull, CT 06611-3465 | 2019-10-25 |
| 1699260109 | Kristen Jean Mosher | Physician Assistant | 31 Cloverdale Ave, Shelton, CT 06484-2538 | 2018-06-27 |
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1962920561 | Eugenie Cho | Physician Assistant | 34 Maple St., Norwalk, CT 06856 | 2017-09-03 |
| 1134536311 | Allyson E Kubasek | Physician Assistant | 32 Seymour Street, Hartford Hospital Orthopedics Dept, Hartford, CT 06102-5037 | 2014-07-19 |
| 1477964344 | Samuel Silva | Physician Assistant | 226 White St., Danbury, CT 06810 | 2014-05-14 |
| Find all providers with the same taxonomy | ||||
| City | TORRINGTON |
| Zip Code | 06790 |
Please comment or provide details below to improve the information on VINCENT J MICCOLI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.