Provider Demographics
NPI:1053480194
Name:EMILY A. NOLFO, M.D., L.L.C.
Entity Type:Organization
Organization Name:EMILY A. NOLFO, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOLFO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-488-4334
Mailing Address - Street 1:5 DURHAM RD STE C2
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2076
Mailing Address - Country:US
Mailing Address - Phone:203-488-4334
Mailing Address - Fax:203-488-7400
Practice Address - Street 1:5 DURHAM RD STE C2
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2076
Practice Address - Country:US
Practice Address - Phone:203-488-4334
Practice Address - Fax:203-488-7400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001308940Medicaid