| Doctor Name: | MR. ROBERTO PREVIATO DOS REIS |
| NPI Number: | 1023239555 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 001904 |
| Business Practice Address: | 40 Cross St Suite 300 Norwalk, CT - 068514647 |
| Business Phone Number: | 2038452200 |
| Business Fax Number: | 2038471940 |
| Mailing Address: | 40 Cross St, Suite 300 NORWALK |
| State: | CT |
| Postal Code: | 068514647 |
| Phone Number: | 2038452200 |
| Fax Number: | 2038471940 |
| NPI Enumeration Date: | 05/01/2007 |
| NPI Last Update Date: | 01/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 001904 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |