Provider Demographics
NPI:1700889094
Name:PATRIGNELLI, ROBERT J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:PATRIGNELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4566
Mailing Address - Country:US
Mailing Address - Phone:203-261-0800
Mailing Address - Fax:203-268-2668
Practice Address - Street 1:965 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4566
Practice Address - Country:US
Practice Address - Phone:203-261-0800
Practice Address - Fax:203-268-2668
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2007-07-23
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
CT033309207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP1033953OtherOXFORD PROVIDER NUMBER
CT2V2765OtherHEALTH NET PROVIDER NUMBE
CT2054081OtherAETNA PROVIDER NUMBER
CTP1033953OtherOXFORD PROVIDER NUMBER