Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 040602 | CT |
Y | 207R00000X | Internist | 040602 | CT |
Y | 111NI0900X | Internist | 040602 | CT |
NPI | 1245200187 |
---|---|
Provider Name | Dr. Andrea A Peterson |
First Address | Norwalk, CT 06850-3852 |
Second Address | Norwalk, CT 06850-3852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 01/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001406025 | (05) | CT |
010040602CT01 | ANTHEM B/C (01) | CT |
110008663 | (02) | |
2254541 | UHC (01) | CT |
2991975 | AETNA (01) | CT |
40602 | CONNECTICARE (01) | CT |
5565197 | CIGNA (01) | CT |
H69738 | (02) | |
OV2706 | HEALTHNET (01) | CT |
P2718821 | OXFORD (01) | CT |