Provider Demographics
NPI:1386760908
Name:DOLCIMASCOLO, FELICE (DC)
Entity type:Individual
Prefix:
First Name:FELICE
Middle Name:
Last Name:DOLCIMASCOLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 663
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CT
Mailing Address - Zip Code:06896-0663
Mailing Address - Country:US
Mailing Address - Phone:203-847-7999
Mailing Address - Fax:203-847-3033
Practice Address - Street 1:430 MAIN AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851
Practice Address - Country:US
Practice Address - Phone:203-847-7999
Practice Address - Fax:203-847-3033
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000876111N00000X
NJ3797111N00000X
NJX005823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050000876CT01OtherBLUE CROSS BLUE SHIELD