Individual
DR. JEFFREY T PRAVDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
863 N. MAIN ST. EXT., SUITE 200, WALLINGFORD, CT 06492-1832
(203) 265-3280
(203) 741-6569
Mailing address
863 N. MAIN ST. EXT., SUITE 200, WALLINGFORD, CT 06492-1832
(203) 265-3280
(203) 741-6569
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
030667
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001306671
—
CT
Enumeration date
07/26/2006
Last updated
07/11/2011
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