Provider Demographics
NPI:1598906067
Name:ALBERT A. CANTITO, D.C. PC
Entity Type:Organization
Organization Name:ALBERT A. CANTITO, D.C. PC
Other - Org Name:MIDDLEBURY CHIROPRACTIC & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MASSIMO
Authorized Official - Middle Name:
Authorized Official - Last Name:VERARDO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-577-2095
Mailing Address - Street 1:590 MIDDLEBURY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-2562
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:590 MIDDLEBURY RD
Practice Address - Street 2:SUITE B
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2562
Practice Address - Country:US
Practice Address - Phone:203-577-2095
Practice Address - Fax:203-577-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-13
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty