Provider Demographics
NPI:1922056951
Name:D'ONOFRIO, DENNIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:D'ONOFRIO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 PECK RD
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-6107
Mailing Address - Country:US
Mailing Address - Phone:860-489-4022
Mailing Address - Fax:860-489-3776
Practice Address - Street 1:52 PECK RD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6107
Practice Address - Country:US
Practice Address - Phone:860-489-4022
Practice Address - Fax:860-489-3776
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000423213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004146347Medicaid
CT004146347Medicaid
CT480000867Medicare ID - Type Unspecified