Provider Demographics
NPI:1962853143
Name:CIPRIANI AMADOR, ABIGAIL COROMOTO (MD)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:COROMOTO
Last Name:CIPRIANI AMADOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 TAMARACK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-5562
Mailing Address - Country:US
Mailing Address - Phone:860-647-8282
Mailing Address - Fax:860-647-8399
Practice Address - Street 1:2701 TAMARACK AVE
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-5562
Practice Address - Country:US
Practice Address - Phone:860-647-8282
Practice Address - Fax:860-647-8399
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT62558208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics