Provider Demographics
NPI:1205815586
Name:POLITO, WILLIAM FRANK (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANK
Last Name:POLITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 LITCHFIELD ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-6669
Mailing Address - Country:US
Mailing Address - Phone:860-489-7017
Mailing Address - Fax:860-489-8943
Practice Address - Street 1:538 LITCHFIELD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6669
Practice Address - Country:US
Practice Address - Phone:860-489-7017
Practice Address - Fax:860-489-8943
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT26224208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LIS030OtherOXFORD
0154903OtherCIGNA
026224OtherCONNECTICARE
CT001315466-01OtherBLUECARE FAMILY PLAN (MCD
2V4880OtherHEALTHNET
CT010026224CT03OtherANTHEM BC/BS
3487058OtherAETNA
3487058OtherAETNA