Individual
DANA CAVICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12 LATHROP ROAD, PLAINFIELD, CT 06374
(860) 564-6293
(860) 564-4879
Mailing address
12 LATHROP ROAD, PLAINFIELD, CT 06374
(860) 564-6293
(860) 564-4879
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
041058
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001410589
—
CT
01
—
010041058CT01
ANTHEM BLUE SHIELF
CT
01
—
041058
CONNECTICARE
CT
01
—
2V3866
HEALTHNET
CT
01
—
P3099896
OXFORD
CT
Enumeration date
08/11/2006
Last updated
06/02/2015
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