Provider Demographics
NPI:1114067907
Name:GADZIK, JAMES PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PAUL
Last Name:GADZIK
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 1:125 KINGS HWY N
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-2428
Mailing Address - Country:US
Mailing Address - Phone:203-226-0771
Mailing Address - Fax:203-226-0417
Practice Address - Street 1:125 KINGS HWY N
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-2428
Practice Address - Country:US
Practice Address - Phone:203-226-0771
Practice Address - Fax:203-226-0417
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT024671208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0083609OtherAETNA
00124671900OtherBCBS FAMILY PLAN
010024671CT01OtherANTHEM BCBS
ZS101OtherOXFORD
020614OtherACS-HEALTHNET
00124671900OtherBCBS FAMILY PLAN
010024671CT01OtherANTHEM BCBS