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DR. JEFFREY SMALL NPI 1740519883


NPI Information

NPI: 1740519883
Provider Name: DR. JEFFREY SMALL
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
4695 MAIN ST
BRIDGEPORT, CT
ZIP 06606
Phone: (203) 372-4419
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DR. JEFFREY SMALL is a specialist in Bridgeport, CT. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. JEFFREY SMALL NPI is 1740519883. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4695 MAIN ST
BRIDGEPORT, CT
ZIP 06606-802
Phone: (203) 372-4419
Fax: (203) 372-4919

The provider's authorized official is Jeffrey Daniel Small .
The authorized official title is Md and has the following contact phone number (203) 372-4419.

The enumeration date for this NPI number is 12/21/2009 and was last updated on 1/14/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistBS3578397CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1125947OTHERCONNECTICUTWELLCARE
24337423OTHERAETNA
3003985OTHERHEALTHNET
401030495CT03OTHERANTHEM BLUE CROSS & BLUE SHIELD
5F01192MEDICARE UPIN
6001304956MEDICAIDCONNECTICUT
7ZS278OTHEROXFORD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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