Basic Information
| Provider Information | |||||||||
| NPI: | 1447260336 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMLETO | ||||||||
| FirstName: | MARIO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 FARM SPRINGS RD | ||||||||
| Address2: | PROHEALTH PHYSICIANS | ||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060322573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602845200 | ||||||||
| FaxNumber: | 8602845333 | ||||||||
| Practice Location | |||||||||
| Address1: | 415 KILLINGWORTH RD | ||||||||
| Address2: | |||||||||
| City: | HIGGANUM | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064414370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8603458535 | ||||||||
| FaxNumber: | 8603458678 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 035027 | CT | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.