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Individual

JEFFREY H WALDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
85 SEYMOUR ST, SUITE 719, HARTFORD, CT 06106-5501
(860) 522-0604
(860) 522-1761
Mailing address
305 WESTERN BLVD, SUITE 100, GLASTONBURY, CT 06033-4380
(860) 522-0604
(860) 522-1761

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
039333
CT
207UN0901X
Nuclear Cardiology Physician
039333
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001393339
CT
01
010039333CT01
ANTHEM BCBS
CT
01
060001459
MCPIN CT HEART PHYSICIANS
CT
01
060066461
RAILROAD MEDICARE
CT
01
C00585
PTAN CONS. CARDIOLOGISTS
CT
01
CA7937
RAILROAD MEDICARE GROUP #
CT
Enumeration date
10/28/2005
Last updated
05/20/2015
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