Provider Demographics
NPI:1114997665
Name:PAZ, ANTONIO (MD)
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:
Last Name:PAZ
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 1:60 OLD NEW MILFORD ROAD
Mailing Address - Street 2:SUITE 3E
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-6099
Mailing Address - Country:US
Mailing Address - Phone:203-775-6205
Mailing Address - Fax:
Practice Address - Street 1:60 OLD NEW MILFORD ROAD
Practice Address - Street 2:SUITE 3E
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-6099
Practice Address - Country:US
Practice Address - Phone:203-775-6205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285384207L00000X, 207R00000X, 208VP0014X
CT043835207R00000X, 208VP0014X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1121403OtherAETNA
CTP3654504OtherOXFORD
CT001438359Medicaid
CT010043835CT01OtherANTHEM B/C
CT043835OtherCONNECTICARE
CT2606317OtherUHC
CT2V7151OtherHEALTHNET
110009745Medicare ID - Type UnspecifiedMEDICARE
CT2V7151OtherHEALTHNET