Provider Demographics
NPI:1295783058
Name:LENDINO, ANTHONY G (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:G
Last Name:LENDINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 FOX HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410
Mailing Address - Country:US
Mailing Address - Phone:203-271-0018
Mailing Address - Fax:203-271-1711
Practice Address - Street 1:546 SOUTH BROAD ST
Practice Address - Street 2:STE 4B
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450
Practice Address - Country:US
Practice Address - Phone:203-634-3905
Practice Address - Fax:203-634-7700
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT021909207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D02884Medicare UPIN
080000115Medicare ID - Type Unspecified