Healthcare Provider Details

I. General information

NPI: 1275554438
Provider Name (Legal Business Name): RONALD S PARET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 07/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

863 N MAIN STREET EXT SUITE 200
WALLINGFORD CT
06492-2434
US

IV. Provider business mailing address

863 N MAIN STREET EXT SUITE 200
WALLINGFORD CT
06492-2434
US

V. Phone/Fax

Practice location:
  • Phone: 203-265-3280
  • Fax: 203-741-6575
Mailing address:
  • Phone: 203-265-3280
  • Fax: 203-741-6575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number027205
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: