Provider Demographics
NPI:1932199296
Name:NINO, ALFREDO F (MD)
Entity Type:Individual
Prefix:
First Name:ALFREDO
Middle Name:F
Last Name:NINO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:SUITE 719
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5501
Mailing Address - Country:US
Mailing Address - Phone:860-522-0604
Mailing Address - Fax:860-522-1761
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 719
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-522-0604
Practice Address - Fax:860-522-1761
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2016-04-01
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Provider Licenses
StateLicense IDTaxonomies
CT015690207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1156900Medicaid
CT1156900Medicaid
CTD99787Medicare UPIN