Basic Information
Provider Information
NPI: 1447493960
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CANTERINO
FirstName: JOSEPH
MiddleName: EMANUEL
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 333 CEDAR ST
Address2: P.O. BOX 208030
City: NEW HAVEN
State: CT
PostalCode: 06520
CountryCode: US
TelephoneNumber: 2036885555
FaxNumber: 2036884516
Practice Location
Address1: 20 YORK ST
Address2: YALE-NEW HAVEN HOSPITAL
City: NEW HAVEN
State: CT
PostalCode: 06510
CountryCode: US
TelephoneNumber: 2036885555
FaxNumber: 2036884516
Other Information
ProviderEnumerationDate: 04/14/2009
LastUpdateDate: 03/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X050735CTY Allopathic & Osteopathic PhysiciansInternal Medicine 
207RI0200X050735CTN Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


Home