Provider Demographics
NPI:1447580808
Name:O'CONNELL, CHARLES WHEELER (CPT)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:WHEELER
Last Name:O'CONNELL
Suffix:
Gender:M
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 UNIVERSITY PL
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3225
Mailing Address - Country:US
Mailing Address - Phone:646-872-1006
Mailing Address - Fax:
Practice Address - Street 1:321 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-2574
Practice Address - Country:US
Practice Address - Phone:646-872-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist