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JEFFREY M FACTOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
836 FARMINGTON AVENUE, SUITE 207, WEST HARTFORD, CT 06119
(860) 232-9911
(860) 233-5996
Mailing address
836 FARMINGTON AVENUE, SUITE 207, WEST HARTFORD, CT 06119
(860) 232-9911
(860) 233-5996

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
031434
CT
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
031434
CT
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
31434
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001314343
CT
01
00131434300
BLUE CROSS MEDICAID
01
004394508
MEDICAID GROUP CAAC
01
010031434CT01
BLUE CROSS
01
0139300005
CIGNA
01
023998
CONNECTICARE
01
043518
AETNA
01
131576
PREFERRED ONE
01
OS2162
HEALTHNET MEDICAID
01
P2666155
OXFORD
Enumeration date
11/09/2005
Last updated
04/14/2022
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