MEDICARE: JANET B DICKINSON 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	207RG0100X	Gastroenterology Physician	024578	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	083105	OTHER	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4124110	OTHER	AETNA
4	010024578CT01	OTHER	BCBS
5	0V0177	OTHER	HEALTH NET
6	530546	OTHER	AETNA
7	724578	OTHER	CT CARE
8	P2639819	OTHER	OXFORD

General Provider Information

NPI Number	:	1942295449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET B DICKINSON MD

Provider Business Mailing Address
First Line	:	199 W MAIN ST
Second Line	:
City	:	MERIDEN
State	:	CT
Zip	:	06451-4024
Country	:	US
Telephone Number	:	203-237-9445
Fax Number	:	203-639-8734

Provider Business Practice Location Address
First Line	:	199 W MAIN ST
Second Line	:
City	:	MERIDEN
State	:	CT
Zip	:	06451-4024
Country	:	US
Telephone Number	:	203-237-9445
Fax Number	:	203-639-8734

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	12/21/2009

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Directions to “ JANET B DICKINSON MD” Practice Location

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