Individual
JON M DURICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1275 SUMMER ST, SUITE 301, STAMFORD, CT 06905-5359
(203) 324-4100
(203) 324-8539
Mailing address
1275 SUMMER ST, SUTEI 301, STAMFORD, CT 06905-5359
(203) 324-4100
(203) 324-8539
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
032876
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010032876CT01
BLUE CROSS-STAMFORD
CT
01
—
010032876CT02
BLUE CROSS-DARIEN
CT
01
—
022213
HEALTHNET
CT
01
—
10444182
CAQH
CT
01
—
4344937
AETNA
CT
01
—
703287
CONNECTICARE
CT
01
—
ZP302
OXFORD
CT
Enumeration date
11/22/2006
Last updated
07/08/2007
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