| John Andrew Intravia, MD | |
|
410 Saybrook Rd, Suite 201, Middletown, CT 06457 | |
| (860) 347-4620 | |
| (860) 346-9687 |
| Full Name | John Andrew Intravia |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Gastroenterology |
| Location | 410 Saybrook Rd, Middletown, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487611588 | NPI | - | NPPES |
| 001206366 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 67730 (Wisconsin) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | 020636 (Connecticut) | Primary |
| Entity Name | Gundersen Lutheran Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225873458 PECOS PAC ID: 2163331414 Enrollment ID: O20130619000254 |
| Mailing Address | Practice Location Address |
|---|---|
| John Andrew Intravia, MD 410 Saybrook Rd, Suite 201, Middletown, CT 06457 Ph: (860) 347-4620 | John Andrew Intravia, MD 410 Saybrook Rd, Suite 201, Middletown, CT 06457 Ph: (860) 347-4620 |
Dr. Miklos C. Fogarasi, M.D. Gastroenterology Medicare: Medicare Enrolled Practice Location: 536 Saybrook Rd, Middletown, CT 06457 Phone: 860-358-2220 Fax: 860-358-2222 | |
George Agyapong, MD Gastroenterology Medicare: Medicare Enrolled Practice Location: 1000 Silver Street, Middletown, CT 06457 Phone: 860-262-5128 | |
Lisa Ochola-tinker, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 28 Crescent St, Middletown, CT 06457 Phone: 860-358-5322 Fax: 860-358-6298 | |
Dr. Mohammed Al-damluji, MD, MPH Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 420 Saybrook Rd Ste A, Middletown, CT 06457 Phone: 860-636-2010 Fax: 860-636-2024 | |
Jude F Clancy, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 420 Saybrook Rd, Middletown, CT 06457 Phone: 203-678-1050 Fax: 860-696-2045 | |
Dr. James Kar-kee Yue, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 760 Saybrook Rd, Middletown, CT 06457 Phone: 860-347-3304 Fax: 860-346-8245 | |
Mario Q Ricci Jr., MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 410 Saybrook Rd, Suite 201, Middletown, CT 06457 Phone: 860-347-4620 Fax: 860-346-9687 |