Provider Demographics
NPI:1093110462
Name:LIVELLA CARE, LLC
Entity Type:Organization
Organization Name:LIVELLA CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ARIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:203-214-4527
Mailing Address - Street 1:4 BRUSHY PLAIN RD
Mailing Address - Street 2:SUITE 519
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-6000
Mailing Address - Country:US
Mailing Address - Phone:203-214-4527
Mailing Address - Fax:
Practice Address - Street 1:4 BRUSHY PLAIN RD
Practice Address - Street 2:SUITE 519
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-6000
Practice Address - Country:US
Practice Address - Phone:203-214-4527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty