Provider Demographics
NPI:1841379534
Name:GELINAS, JOHN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:GELINAS
Suffix:JR
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 1:57 NORTH ST
Mailing Address - Street 2:SUITE 419
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5660
Mailing Address - Country:US
Mailing Address - Phone:203-778-2020
Mailing Address - Fax:203-778-4040
Practice Address - Street 1:57 NORTH ST
Practice Address - Street 2:SUITE 419
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5660
Practice Address - Country:US
Practice Address - Phone:203-778-2020
Practice Address - Fax:203-778-4040
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT-033091174400000X, 2084P0800X
CT0330912084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT061531381OtherTAX ID #