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Contact Information

ANICA ANTIC, MD
365 MONTAUK AVE
NEW LONDON, CT06320-4700
 Phone: 860-444-5100
 Fax: 860-444-3709
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for ANICA ANTIC · (Female)

NPI Number 1457678641
Status Active
Credentials MD
Entity Individual
Enumeration date 04/27/2010
Last updated 10/24/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 049493
  • CT Medicaid 008031615
Hospital affiliation(s)
  • LAWRENCE & MEMORIAL HOSPITAL - (Acute Care)
    365 MONTAUK AVE
    NEW LONDON, CT 06320
  • WESTERLY HOSPITAL - (Acute Care)
    25 WELLS STREET
    WESTERLY, RI 02891
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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