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NPI Code Detail

MEDICARE: DR. ANGELA G GEDDIS M.D.

MEDICARE: DR. ANGELA G GEDDIS M.D.
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
1208000000XPediatrics Physician031048CT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10126638OTHERCTWELLCARE MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1060040OTHERCTHEALTH NET ID
21255448155OTHERCTGHMC NPI ID
3476805OTHERCTAETNA REF ID
4010031048CT03OTHERCTBCBS NBCFP PLAINVILLE ID
5010031048CT04OTHERCTBCBSN BCFP NB ID
601031048OTHERCTCIGNA ID
7912429OTHERCTHEALTH NET REF ID
871668401OTHERCTCONNECTICARE ID
9P369863OTHERCTOXFORD ID

General Provider Information

NPI Number : 1316943285
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA G GEDDIS M.D.
Provider Business Mailing Address
First Line : 300 KENSINGTON AVE
Second Line :
City : NEW BRITAIN
State : CT
Zip : 06051-3916
Country : US
Telephone Number : 860-224-6282
Fax Number : 860-826-4959
Provider Business Practice Location Address
First Line : 184 EAST ST
Second Line :
City : PLAINVILLE
State : CT
Zip : 06062-2913
Country : US
Telephone Number : 860-747-1132
Fax Number : 860-747-2028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 07/09/2007

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