Protiva, Petr

Protiva, Petr is an individual health care provider with primary practice located at 950 Campbell Ave Department Of Medicine, Bld 1, 5Th Floor, West Haven CT 06516-2770. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Protiva, Petr can be contacted via phone (203) 932-5711.

Contact Information

Primary practice address
950 Campbell Ave Department Of Medicine, Bld 1, 5Th Floor West Haven CT 06516-2770
Phone: (203) 932-5711
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 044277 Connecticut

Profile Details

NPI number 1962447409
LBN Legal business name Protiva, Petr
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2006
Last updated Jun 12th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962447409 NPPES
Connecticut MEDICAID 1442772

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