Provider Demographics
NPI:1700825593
Name:LETTERA, JAMES V (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:V
Last Name:LETTERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:501 KINGS HWY E
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-4867
Mailing Address - Country:US
Mailing Address - Phone:203-382-1900
Mailing Address - Fax:203-382-0019
Practice Address - Street 1:501 KINGS HWY E
Practice Address - Street 2:SUITE 112
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-4867
Practice Address - Country:US
Practice Address - Phone:203-382-1900
Practice Address - Fax:203-382-0019
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0258712086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010025871CT01OtherANTHEM BLUE CROSS
CT0V5163OtherHEALTH NET
CT001258714Medicaid
CT525871OtherCONNECTICARE
CTZS185OtherOXFORD
CTZS185OtherOXFORD
CT010025871CT01OtherANTHEM BLUE CROSS