Provider Demographics
NPI:1053381475
Name:CANTITO, ALBERT A (DC)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:A
Last Name:CANTITO
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 1:2030 STRAITS TPKE
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1831
Mailing Address - Country:US
Mailing Address - Phone:203-577-2095
Mailing Address - Fax:203-577-2098
Practice Address - Street 1:2030 STRAITS TPKE
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1831
Practice Address - Country:US
Practice Address - Phone:203-577-2095
Practice Address - Fax:203-577-2098
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT695638OtherFOCUS
CTCT01129OtherLANDMARK
CT5493332003OtherCIGNA
CT050001129CT03OtherANTHEM BCBS
CT5861660OtherAETNA
CTNER0104181OtherHEALTHSOURCE
CT944630OtherHEALTH NET
CT715162OtherCONNECTICARE
CTP2106180OtherOXFORD
CT050001129CT03OtherANTHEM BCBS