Provider Demographics
NPI:1336336437
Name:ANTHONY G LENDINO M.D. LLC
Entity type:Organization
Organization Name:ANTHONY G LENDINO M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:G
Authorized Official - Last Name:LENDINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-634-3905
Mailing Address - Street 1:546 S BROAD ST
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-6600
Mailing Address - Country:US
Mailing Address - Phone:203-634-3905
Mailing Address - Fax:
Practice Address - Street 1:546 S BROAD ST
Practice Address - Street 2:SUITE 4B
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-6600
Practice Address - Country:US
Practice Address - Phone:203-634-3905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT021909207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC01928Medicare PIN