Provider Demographics
NPI:1588026280
Name:D'AMICO, TIMOTHY ALBERT (DO)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ALBERT
Last Name:D'AMICO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAND ST STE E119
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-2016
Mailing Address - Country:US
Mailing Address - Phone:860-224-5305
Mailing Address - Fax:860-224-5740
Practice Address - Street 1:100 GRAND ST
Practice Address - Street 2:THE HOSPITAL OF CENTRAL CONNECTICUT
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2016
Practice Address - Country:US
Practice Address - Phone:860-224-5261
Practice Address - Fax:860-224-5957
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT064891207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine