Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 028734 | CT |
NPI | 1225074412 |
---|---|
Provider Name | Dr. Ellison Berns |
First Address | Hartford, CT 06105-1770 |
Second Address | Hartford, CT 06105-1770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 13/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001287342 | (05) | CT |
010028734CT02 | BLUE CROSS & BLUE SHIELD (01) | |
0210490004 | CIGNA HEALTH PLANS (01) | |
060058732 | RAILROAD MEDICARE (01) | |
0V6122 | HEALTHNET (01) | |
1217506 | UNITED HEALTHCARE (01) | |
2262193 | AETNA HEALTH PLANS (01) | |
287340 | CONNECTICARE (01) | |
C65004 | (02) | |
HAS247 | OXFORD HEALTH PLANS (01) |