Petruff, Carol
Petruff, Carol is an individual health care provider with primary practice located at 44 Dale Rd Prime Healthcare, Avon CT 06001-3612. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Petruff, Carol can be contacted via phone (860) 674-8830.Contact Information
Primary practice address
44 Dale Rd Prime Healthcare
Avon CT 06001-3612
Phone: (860) 674-8830
Fax: (860) 674-8984
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 033353 | Connecticut |
Profile Details
| NPI number | 1083691794 |
|---|---|
| LBN Legal business name | Petruff, Carol |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 23rd, 2005 |
| Last updated | Mar 7th, 2023 - about last year |
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 | 1083691794 | NPPES |
| Connecticut | Other | 010033353CT01 | BCBS |
| Connecticut | Other | 033353 | BCBS |
| Connecticut | MEDICAID | 001333533 | BCBS |
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