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1548930936
MICHAEL CONSTANTINE ANTONELLIS
BRIDGEPORT, CT
NPI
1548930936
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CT 6627)
Additional Taxonomies
363A00000X Physician Assistant
Enumeration Date
2021-09-16
Last Update Date
2024-09-18
Business Address
MICHAEL CONSTANTINE ANTONELLIS
2800 MAIN STREET DEPT OF SURGERY
BRIDGEPORT, CT 06606
Phone number: 475-210-6512
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Mailing Address
MICHAEL CONSTANTINE ANTONELLIS
1290 SILAS DEANE HWY
WETHERSFIELD, CT 06109-4337
Phone number: 203-909-4171
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