Provider Demographics
NPI:1609098102
Name:SCLAFANI, LEONARDO JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:JOSEPH
Last Name:SCLAFANI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-3619
Mailing Address - Country:US
Mailing Address - Phone:203-831-0006
Mailing Address - Fax:203-831-0614
Practice Address - Street 1:188 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-3619
Practice Address - Country:US
Practice Address - Phone:203-831-0006
Practice Address - Fax:203-831-0614
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000982111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP743138OtherOXFORD HEALTH
CT050000982CT01OtherANTHEM BCBS
CT657831OtherCONNECTICARE