GERALD MICALIZZI, M.D., LLC
Radiology at Fairview Ave, Bridgeport, CT

License number
Connecticut 225913-1
Category
Radiology
Type
Diagnostic Ultrasound
Owner
Name: DR. GERALD JOSEPH MICALIZZI M.D.
Title: PRESIDENT
Phone: (203) 260-2493
Address
Address
558 Fairview Ave, Bridgeport, CT 06606
National Provider ID: 1487997581
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GERALD MICALIZZI, M.D., LLC

558 Fairview Ave, Bridgeport, CT 06606

Industry:
Medical Doctor's Office
Doing business as:
Gerald Micalizzi MD
Registration:
Jul 2, 2007
State ID:
0904708
Business type:
Domestic Limited Liability Company
Medical Doctor, Principals:
Gerald Micalizzi, M.d (Member), 558 Fairview Ave, Bridgeport, CT 06606 (Mailing),Gerald Micalizzi (Medical Doctor, Principal)
Agent:
Esquire Justin K. Falco,66 Huntington St, Shelton, CT 06484 (Mailing)
84 Milford Pt Rd, Milford, CT 06460 (Physical)

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