Provider Demographics
NPI:1336126846
Name:SALVIETTI, RALPH J (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:J
Last Name:SALVIETTI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1086
Mailing Address - Street 2:HARTFORD MEDICAL GROUP
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-1086
Mailing Address - Country:US
Mailing Address - Phone:508-595-0531
Mailing Address - Fax:508-829-5367
Practice Address - Street 1:200 RETREAT AVE
Practice Address - Street 2:DONNELLY BUILDING
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3309
Practice Address - Country:US
Practice Address - Phone:860-545-7224
Practice Address - Fax:860-545-7482
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2013-02-25
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Provider Licenses
StateLicense IDTaxonomies
CT023668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001236686Medicaid
CT080001074Medicare ID - Type Unspecified
CT001236686Medicaid