Provider Demographics
NPI:1700389087
Name:DAMICO, ANTHONY CHRISTOPHER (DO)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHRISTOPHER
Last Name:DAMICO
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:367 ORANGE ST APT 631
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-6464
Mailing Address - Country:US
Mailing Address - Phone:630-770-7240
Mailing Address - Fax:
Practice Address - Street 1:1100 WILFORD HALL LOOP BLDG 4554
Practice Address - Street 2:
Practice Address - City:JBSA LACKLAND
Practice Address - State:TX
Practice Address - Zip Code:78236-5638
Practice Address - Country:US
Practice Address - Phone:210-292-6255
Practice Address - Fax:210-292-7934
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT775112084P0800X
HIDOS-20442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry