Brody, Richard L
Brody, Richard L is an individual health care provider with primary practice located at 1315 Main St Suite 2, Willimantic CT 06226-1948. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Brody, Richard L can be contacted via phone (860) 450-7471.Contact Information
Primary practice address
1315 Main St Suite 2
Willimantic CT 06226-1948
Phone: (860) 450-7471
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 142207 | Connecticut |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 42207 | Connecticut |
Profile Details
| NPI number | 1457330912 |
|---|---|
| LBN Legal business name | Brody, Richard L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 12th, 2006 |
| Last updated | Nov 22nd, 2011 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457330912 | NPPES |
| Connecticut | Other | 010042204CT01 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 145674 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 3985938 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 3487457015 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | MEDICAID | 001422071 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 080001731 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | PAR | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 11113774 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 1457330912 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 007733871 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 145674-G525 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 2444498 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | P3319349 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 7896129 | ANTHEM BCBS (GENERATIONS) |
| Connecticut | Other | 2V5016 | ANTHEM BCBS (GENERATIONS) |
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