1124137286 NPI number — MR. JOHN T DUNLOP MD

Table of content: MR. JOHN T DUNLOP MD (NPI 1124137286)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124137286 NPI number — MR. JOHN T DUNLOP MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNLOP
Provider First Name:
JOHN
Provider Middle Name:
T
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124137286
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
874 HOWARD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-688-8200
Provider Business Mailing Address Fax Number:
203-688-8204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
874 HOWARD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-688-8200
Provider Business Practice Location Address Fax Number:
203-688-8204
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  52936 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5476347 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1124137286 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 446815 . This is a "HEALTHY CT" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1124137286 . This is a "ANTHEM" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1124137286 . This is a "MULTIPLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P01396400 . This is a "RR MEDICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1289323 . This is a "COVENTRY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1124137286 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: AA417900 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1124137286 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1077074 . This is a "WELLCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1124137286 . This is a "TRICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P5110395 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 4403455 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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