IndividualActive
Nicholas Mongillo, M.D.
NPI 1073536710 · Pediatric Adolescent Medicine Physician · Shelton, CT
Provider details
- NPI number
- 1073536710
- Entity type
- Individual
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 030893 (CT)
Practice location
25 Constitution Blvd. So
Shelton, CT 06484-4351
Phone: (203) 924-7334
Fax: (203) 922-0004
Mailing address
25 Constitution Blvd S
Shelton, CT 06484-4351
Registry dates
- Enumerated
- 2006-07-25
- Last updated
- 2017-01-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.