MICHAEL CONSTANTINE ANTONELLIS
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1548930936- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 2800 MAIN STREET DEPT OF SURGERY, BRIDGEPORT, CT, 06606
- Phone
- (475) 210-6512
Specialties & Taxonomies
Physician Assistant
Physician Assistant
Primary License: CT #6627