Provider Demographics
NPI:1710986377
Name:MCAULIFFE, GERALD V (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:V
Last Name:MCAULIFFE
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 1:300 KENSINGTON AVE
Mailing Address - Street 2:GROVE HILL MEDICAL CENTER
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3916
Mailing Address - Country:US
Mailing Address - Phone:860-832-8150
Mailing Address - Fax:860-224-6953
Practice Address - Street 1:300 KENSINGTON AVE
Practice Address - Street 2:GROVE HILL MEDICAL CENTER
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-3916
Practice Address - Country:US
Practice Address - Phone:860-832-8150
Practice Address - Fax:860-224-6953
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT018392207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060107OtherHEALTH NET PROV ID
CT511554OtherAETNA PROV ID
CT001183920Medicaid
CT004215324Medicaid
CT01218392OtherCIGNA PROV ID
CT132226OtherWELLCARE MEDICARE
CT914792OtherHEALTH NET REF ID
CT1255448155OtherGHMC GRP NPI ID
CT050065OtherCONNECTICARE PROV ID
CT010018392CT02OtherBCBS N BCFP PROV ID
CTP369808OtherOXFORD PROV ID
CT1255448155OtherGHMC GRP NPI ID
CTC01373Medicare ID - Type UnspecifiedGHMC GRP MEDICARE ID
CT110005773Medicare ID - Type Unspecified