Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 017073 | CT |
NPI | 1013952274 |
---|---|
Provider Name | Dr. Paul Cerza |
First Address | West Hartford, CT 06137-0337 |
Second Address | Manchester, CT 06040-4131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 13/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010017073CT02 | ANTHEM BLUE (01) | CT |
050614 | CONNECTICARE (01) | CT |
073881 | AETNA (01) | CT |
B83129 | (02) | CT |
HAS 727 | OXFORD HEALTH PLAN (01) | CT |
OVO 141 | HEALTHNET (01) | CT |