| Doctor Name: | DR. NIV E DECALO |
| NPI Number: | 1053511667 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 045841 |
| Business Practice Address: | 111 Founders Plz Suite 400 East Hartford, CT - 061083212 |
| Business Phone Number: | 8602893375 |
| Business Fax Number: | 8607835733 |
| Mailing Address: | 111 Founders Plz, Suite 400 EAST HARTFORD |
| State: | CT |
| Postal Code: | 061083212 |
| Phone Number: | 8602893375 |
| Fax Number: | 8607835733 |
| NPI Enumeration Date: | 07/21/2007 |
| NPI Last Update Date: | 02/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 045841 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |