Individual
RICHARD SIAHAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
421 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-3170
(860) 242-0034
(860) 242-3301
Mailing address
421 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-3170
(860) 242-0034
(860) 242-3301
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
024303
CT
207R00000X
Internal Medicine Physician
Primary
24303
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004263612
CHN
CT
05
—
004263612
—
CT
01
—
010024303CT01
BLUESHIELD
CT
01
—
0V0438
HEALTHNET
CT
01
—
1751515
UNITED HEALTHCARE
GA
01
—
369877
WELLCARE
CT
01
—
427750
TUFTS
MA
01
—
514837
AETNA
TX
01
—
704554
CONNECTICARE
CT
01
—
7294618
CIGNA
PA
01
—
80705
GREATWEST
CT
01
—
P3592661
OXFORD
CT
Enumeration date
04/18/2007
Last updated
12/28/2016
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