Individual
DR. JONATHAN ROBERT REIDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
64 BLACK ROCK AVENUE, BRIDGEPORT, CT 06605-1200
(203) 579-5000
(203) 579-5113
Mailing address
64 BLACK ROCK AVENUE, BRIDGEPORT, CT 06605-1200
(203) 576-3885
(203) 683-3620
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
044890
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001448902
—
CT
05
—
004195930
—
CT
05
—
004234788
—
CT
01
—
010044890CT01
BCBS & BCFP PROV ID
CT
01
—
1255448155
GHMC GROUP NPI ID
CT
01
—
1470175
AETNA
CT
01
—
227660
CONNECTICARE
CT
01
—
2V8732
HEALTH NET
CT
01
—
369523
WELLCARE MEDICARE
CT
01
—
7615732
CIGNA
CT
01
—
P3735238
OXFORD
CT
Enumeration date
11/08/2006
Last updated
02/02/2026
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