Provider Demographics
NPI:1366444135
Name:CIAMPI, MARC A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:A
Last Name:CIAMPI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:140 GRANDVIEW AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2505
Mailing Address - Country:US
Mailing Address - Phone:203-597-9733
Mailing Address - Fax:203-597-9732
Practice Address - Street 1:140 GRANDVIEW AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2505
Practice Address - Country:US
Practice Address - Phone:203-597-9733
Practice Address - Fax:203-597-9732
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT037620207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001376202Medicaid
CT390000167Medicare ID - Type Unspecified
CTH34486Medicare UPIN