Radebold, Andrea

Radebold, Andrea is an individual health care provider with primary practice located at 960 Main St , Branford CT 06405-3730. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Radebold, Andrea can be contacted via phone (203) 488-6358.

Contact Information

Primary practice address
960 Main St Branford CT 06405-3730
Phone: (203) 488-6358
Fax: (203) 481-5327
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 042296 Connecticut

Profile Details

NPI number 1942264288
LBN Legal business name Radebold, Andrea
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated Feb 3rd, 2022 - about 3 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 1942264288 NPPES
Other 010042296CT01 ANTHEM BCBS
Other P00140199 ANTHEM BCBS
MEDICAID 001422964 ANTHEM BCBS
Other 042296 ANTHEM BCBS
Other 3680171 ANTHEM BCBS
Other 0Q2728 ANTHEM BCBS
Other P3340613 ANTHEM BCBS

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