Organization
DR. JEFFREY SMALL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY DANIEL SMALL (MD)
(203) 372-4419
Entity
Organization
Contact information
Practice address
4695 MAIN ST, BRIDGEPORT, CT 06606-1802
(203) 372-4419
(203) 372-4919
Mailing address
4695 MAIN ST, BRIDGEPORT, CT 06606-1802
(203) 372-4419
(203) 372-4919
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BS3578397
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001304956
—
CT
01
—
003985
HEALTHNET
—
01
—
01030495CT03
ANTHEM BLUE CROSS & BLUE SHIELD
—
01
—
125947
WELLCARE
CT
01
—
4337423
AETNA
—
01
—
ZS278
OXFORD
—
Enumeration date
12/21/2009
Last updated
01/14/2010
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