Provider Demographics
NPI:1255966222
Name:MEDICA TODAY LLC
Entity type:Organization
Organization Name:MEDICA TODAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP-C
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANON
Authorized Official - Middle Name:C
Authorized Official - Last Name:BICEGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:203-816-5551
Mailing Address - Street 1:PO BOX 921
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-0921
Mailing Address - Country:US
Mailing Address - Phone:203-816-5551
Mailing Address - Fax:203-816-5551
Practice Address - Street 1:555 HIGHLAND AVE STE 23
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2255
Practice Address - Country:US
Practice Address - Phone:203-816-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty