Provider Demographics
NPI:1033206826
Name:IONUT ANTON M.D. PC
Entity Type:Organization
Organization Name:IONUT ANTON M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IONUT
Authorized Official - Middle Name:B
Authorized Official - Last Name:ANTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-596-1909
Mailing Address - Street 1:171 GRANDVIEW AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2517
Mailing Address - Country:US
Mailing Address - Phone:203-596-1906
Mailing Address - Fax:203-596-1861
Practice Address - Street 1:171 GRANDVIEW AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2517
Practice Address - Country:US
Practice Address - Phone:203-596-1906
Practice Address - Fax:203-596-1861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT040407261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care