Individual
DR. JOHN GERALD PITEGOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1225 SILVER ST, MIDDLETOWN, CT 06457-3920
(860) 638-2620
(860) 638-2630
Mailing address
20 HIGH POINT LN, WEST HARTFORD, CT 06107-1135
(860) 232-3314
(860) 232-1867
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
026828
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001268285
—
CT
01
—
010026828CT
ANTHEM BLUE CARE
CT
Enumeration date
09/01/2006
Last updated
09/15/2011
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