1811990013 NPI number — DR. PAUL H DEUTSCH MD, RPH

Table of content: DR. PAUL H DEUTSCH MD, RPH (NPI 1811990013)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811990013 NPI number — DR. PAUL H DEUTSCH MD, RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEUTSCH
Provider First Name:
PAUL
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, RPH
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:
1811990013
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
86 NEW LONDON TPKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWICH
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06360-2616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-889-6967
Provider Business Mailing Address Fax Number:
860-885-1033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
86 NEW LONDON TPKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWICH
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06360-2616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-889-6967
Provider Business Practice Location Address Fax Number:
860-889-7113
Provider Enumeration Date:
05/23/2005

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:  025700 , 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: 030043 . This is a "HEALTH NET OF THE NORTHEA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001257005 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: NLP011 . This is a "OXFORD HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 736987 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01025700 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00125700500 . This is a "BLUECARE FAMILY PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0443085 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4310284 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010025700CT01 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 104604600 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".




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