IndividualActive
Dennis Custodio, INDEPENDENT DUTY HM
NPI 1013264423 · Independent Duty Corpsman · Groton, CT
Provider details
- NPI number
- 1013264423
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- INDEPENDENT DUTY HM
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Practice location
69 Trout Ave
Naval Undersea Medical Institute
Groton, CT 06349
Phone: (253) 905-8239
Approximate (ZIP-level) locationGet directions
Mailing address
6910 227th Street Ct E
Spanaway, WA 98387-5841
Registry dates
- Enumerated
- 2012-08-06
- Last updated
- 2012-08-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.