Provider Demographics
NPI:1336532647
Name:ROBERT J PATRIGNELLI MD PC
Entity Type:Organization
Organization Name:ROBERT J PATRIGNELLI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATRIGNELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-261-0800
Mailing Address - Street 1:17 CHURCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-3116
Mailing Address - Country:US
Mailing Address - Phone:203-261-0800
Mailing Address - Fax:203-268-2668
Practice Address - Street 1:17 CHURCH HILL RD
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-3116
Practice Address - Country:US
Practice Address - Phone:203-261-0800
Practice Address - Fax:203-268-2668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033309207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty