Provider Demographics
NPI:1770646689
Name:SOMOGYI, BALAZS BELA (MD)
Entity Type:Individual
Prefix:
First Name:BALAZS
Middle Name:BELA
Last Name:SOMOGYI
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 1:10 GEORGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410
Mailing Address - Country:US
Mailing Address - Phone:203-271-0659
Mailing Address - Fax:203-271-0285
Practice Address - Street 1:10 GEORGE AVE
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410
Practice Address - Country:US
Practice Address - Phone:203-271-0659
Practice Address - Fax:203-271-0285
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT016126207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
010016126CT02OtherANTHEM
CT1161264Medicaid
0R0623OtherHEALTHNET
010016126CT01OtherANTHEM
CT1161264Medicaid