Provider Demographics
NPI:1386095487
Name:GILIO, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:GILIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 HELEN ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-4415
Mailing Address - Country:US
Mailing Address - Phone:203-248-5466
Mailing Address - Fax:203-248-5466
Practice Address - Street 1:145 HELEN ST
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-4415
Practice Address - Country:US
Practice Address - Phone:203-248-5466
Practice Address - Fax:203-248-5466
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT022583208D00000X, 207P00000X, 2085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology