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1487618369

NPI Code Detail

MEDICARE: DR. RYAN T O'CONNELL MD

MEDICARE: DR. RYAN T O'CONNELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	039650	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	110248572	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	039650	OTHER		CONNECTICARE
2	3254639	OTHER		AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0Q3462	OTHER		HEALTHNET
5	P2834865	OTHER		OXFORD
6	010039650CT01	OTHER		ANTHEM BCBS

General Provider Information

NPI Number	:	1487618369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN T O'CONNELL MD

Provider Business Mailing Address
First Line	:	1290 SILAS DEANE HWY
Second Line	:	HARTFORD HEALTHCARE-CVO
City	:	WETHERSFIELD
State	:	CT
Zip	:	06109-4337
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 MAIN ST
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06606-4201
Country	:	US
Telephone Number	:	475-210-5718
Fax Number	:	475-210-5263

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	02/10/2023

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Directions to “ DR. RYAN T O'CONNELL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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