Provider Demographics
NPI:1811916257
Name:ARCIERO, THOMAS (DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:ARCIERO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 W MAIN ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2764
Mailing Address - Country:US
Mailing Address - Phone:203-754-2225
Mailing Address - Fax:203-754-2205
Practice Address - Street 1:1127 W MAIN ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2764
Practice Address - Country:US
Practice Address - Phone:203-754-2225
Practice Address - Fax:203-754-2205
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050001346CT01OtherANTHEM BLUE CROSS AND BLUE SHIELD
CT004248200Medicaid
CT050001346CT01OtherANTHEM BLUE CROSS AND BLUE SHIELD
CTV02519Medicare UPIN
CT350001366Medicare ID - Type Unspecified