Individual
JEFFREY A HERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
79 WAWECUS ST, STE 105, NORWICH, CT 06360
(860) 886-0161
(860) 889-5999
Mailing address
79 WAWECUS ST, STE 105, NORWICH, CT 06360
(860) 886-0161
(860) 889-5999
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
023601
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001236017
—
CT
01
—
010023601CT01
BCS
CT
01
—
031460
HEALTH NET
CT
01
—
0584458002
CIGNA
—
01
—
0804876
UNITED HEALTHCARE
—
01
—
181413
PREFERRED ONE
—
01
—
566780
AETNA
—
01
—
732141
CONNECTICARE
—
01
—
NLS055
OXFORD
—
Enumeration date
07/03/2006
Last updated
11/12/2009
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