Reidel, Jonathan Robert

Reidel, Jonathan Robert is an individual health care provider with primary practice located at 375 Willard Ave Grove Hill Medical Center, Newington CT 06111-2300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Reidel, Jonathan Robert can be contacted via phone (860) 666-5167.

Contact Information

Primary practice address
375 Willard Ave Grove Hill Medical Center Newington CT 06111-2300
Phone: (860) 666-5167
Fax: (860) 665-8168
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 044890 Connecticut

Profile Details

NPI number 1184793481
LBN Legal business name Reidel, Jonathan Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2006
Last updated Apr 1st, 2013 - about 13 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 1184793481 NPPES
Connecticut Other P3735238 OXFORD
Connecticut Other 7615732 OXFORD
Connecticut MEDICAID 004195930 OXFORD
Connecticut Other 227660 OXFORD
Connecticut Other 369523 OXFORD
Connecticut MEDICAID 001448902 OXFORD
Connecticut Other 010044890CT01 OXFORD
Connecticut Other 1255448155 OXFORD
Connecticut Other 1470175 OXFORD
Connecticut Other 2V8732 OXFORD

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