Provider Demographics
NPI:1043221179
Name:DAFCIK, ADRIAN (MD)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:
Last Name:DAFCIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:ADRIAN
Other - Middle Name:
Other - Last Name:DAFCIK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:134 ROUND HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824
Mailing Address - Country:US
Mailing Address - Phone:203-255-0695
Mailing Address - Fax:203-255-0629
Practice Address - Street 1:134 ROUND HILL ROAD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824
Practice Address - Country:US
Practice Address - Phone:203-255-0695
Practice Address - Fax:203-255-0629
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032343207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZP470OtherOXFORD
CT004183OtherHEALTH NET
CT010032343CT01OtherBCBS
CT001323435Medicaid
CT001323435Medicaid
CT110006808Medicare ID - Type Unspecified