Provider Demographics
NPI:1679538862
Name:NAPOLITANO, JOHN GUIDO (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:GUIDO
Last Name:NAPOLITANO
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:115 TECHNOLOGY DR UNIT B106
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-6339
Mailing Address - Country:US
Mailing Address - Phone:203-372-6460
Mailing Address - Fax:203-372-6470
Practice Address - Street 1:115 TECHNOLOGY DR UNIT B106
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-6339
Practice Address - Country:US
Practice Address - Phone:203-372-6460
Practice Address - Fax:203-372-6470
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT001510363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q29444Medicare UPIN