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Individual

PACEY PET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
146 DANBURY RD, NEW MILFORD, CT 06776-3427
(860) 799-5900
(860) 799-5902
Mailing address
146 DANBURY RD, NEW MILFORD, CT 06776-3427
(860) 799-5900
(860) 799-5902

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30074
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004068508
CT
01
4329521
AETNA
CT
01
730074
CONNECTICARE
01
9896287
CIGNA
01
P4302536
OXFORD
Enumeration date
02/02/2006
Last updated
03/03/2017
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