Provider Demographics
NPI:1376647420
Name:MAGRAW, RUTH J (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:J
Last Name:MAGRAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 HALLS POINT ROAD
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405
Mailing Address - Country:US
Mailing Address - Phone:203-481-8990
Mailing Address - Fax:
Practice Address - Street 1:374 GRAND AVENUE
Practice Address - Street 2:FAIR HAVEN COMMUNITY HEALTH CTR
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513
Practice Address - Country:US
Practice Address - Phone:203-777-7411
Practice Address - Fax:203-777-8506
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026597208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
726597OtherCF & CARE
010026597CT02OtherATHEM BCBS BLUCARE
1051526OtherAETNA US HEALTH
01026597OtherCIGNA
P804453OtherOXFORD
01026597OtherCIGNA
726597OtherCF & CARE