Individual
DERMOT M MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
874 HOWARD AVE, NEW HAVEN, CT 06519-1106
(203) 688-8200
(203) 688-8204
Mailing address
874 HOWARD AVE, NEW HAVEN, CT 06519-1106
(203) 688-8200
(203) 688-8204
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000997
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000997
CONNECTICARE
CT
01
—
061561581
UNITED HEALTHCARE
CT
01
—
0Q2937
HELATH NET
CT
01
—
290000997CT01
ANTHEM BC/BS
CT
01
—
369530
WELLCARE OF CT
CT
01
—
970019423
RAIL ROAD MEDICARE
CT
01
—
P2531898
OXFORD
CT
Enumeration date
08/02/2005
Last updated
01/09/2009
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