Provider Demographics
NPI:1861685943
Name:DR. PETER D. SCHIOPPO, LLC
Entity Type:Organization
Organization Name:DR. PETER D. SCHIOPPO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:AP
Authorized Official - Last Name:SCHIOPPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-562-4051
Mailing Address - Street 1:633 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3824
Mailing Address - Country:US
Mailing Address - Phone:203-562-4051
Mailing Address - Fax:203-865-7567
Practice Address - Street 1:633 ORANGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3824
Practice Address - Country:US
Practice Address - Phone:203-562-4051
Practice Address - Fax:203-865-7567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6731103-000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC01484Medicare PIN