Provider Demographics
NPI:1780681353
Name:PRINGLE, REBECCA (MD, PH D)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:MD, PH D
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:BOGY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:675 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3153
Mailing Address - Country:US
Mailing Address - Phone:203-250-2125
Mailing Address - Fax:203-250-2162
Practice Address - Street 1:675 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3153
Practice Address - Country:US
Practice Address - Phone:203-272-1811
Practice Address - Fax:203-271-3152
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038516207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001385162Medicaid
CT010038516CT01OtherANTHEM
0740983OtherUNITED HEALTHPLAN
CT0Q2448OtherHEALTHNET
CTP2065295OtherOXFORD HEALTH PLAN
CT038516OtherCONNECTICARE
CT07-40983OtherUNITED HEALTH PLANS
2316267OtherAETNA
CT8197592-002OtherCIGNA
CT1600001875Medicare ID - Type Unspecified
CT001385162Medicaid
2316267OtherAETNA