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Individual

DR. JONATHAN PENDLETON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
184 EAST ST, GROVE HILL MEDICAL CENTER, PLAINVILLE, CT 06062-2913
(860) 747-5766
(860) 747-2028
Mailing address
300 KENSINGTON AVE, GROVE HILL MEDICAL CENTER, NEW BRITAIN, CT 06051-3916
(860) 747-5766
(860) 747-2028

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
022201
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001222017
CT
05
004215324
CT
01
010022201CT01
BCBS & BCFP ID
CT
01
01022201
CIGNA
CT
01
060031
HEALTH NET
CT
01
110116250
RAIL ROAD MEDICARE ID
CT
01
1255448155
GHMC GROUP NPI ID
CT
01
135678
WELLCARE MEDICARE
CT
01
477354
AETNA
CT
01
5978401
CONNECTICARE
CT
01
P369805
OXFORD
CT
Enumeration date
08/12/2005
Last updated
07/09/2007
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