Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 024378 | CT |
NPI | 1063451201 |
---|---|
Provider Name | Dr. Paul Dean Demartini |
First Address | Fairfield, CT 06825-4867 |
Second Address | Fairfield, CT 06825-4867 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 27/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001243781 | (05) | CT |
010024378CT01 | ANTHEM BLUE CROSS (01) | CT |
0V5159 | HEALTH NET (01) | CT |
524378 | CONNECTICARE (01) | CT |
E45506 | (02) | CT |
ZS218 | OXFORD (01) | CT |