1245364041 NPI number — DR. JOHN CHRISTOPHER SOVA D.C.

Table of content: DR. JOHN CHRISTOPHER SOVA D.C. (NPI 1245364041)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245364041 NPI number — DR. JOHN CHRISTOPHER SOVA D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOVA
Provider First Name:
JOHN
Provider Middle Name:
CHRISTOPHER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
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:
1245364041
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 ELM ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06468-1804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-452-1110
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWALK
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06851-2720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-847-2600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2007

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: 111N00000X , with the licence number:  001286 , 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: 7242622 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 68WLKN026CT01 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3736521 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 3392961 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P3407583 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 23-2189859 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2V5977 . This is a "HEALHTNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 24440555 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3134633002 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: OV9213 . This is a "PHS" identifier . This identifiers is of the category "OTHER".
  • Identifier: CT1286C . This is a "LANDMARK" identifier . This identifiers is of the category "OTHER".




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