Provider Demographics
NPI:1891797775
Name:PARIS, JAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:R
Last Name:PARIS
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:860-223-0220
Mailing Address - Fax:860-826-4962
Practice Address - Street 1:1 LAKE ST
Practice Address - Street 2:GROVE HILL MEDICAL CENTER
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1396
Practice Address - Country:US
Practice Address - Phone:860-223-0220
Practice Address - Fax:860-826-4962
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027770207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT01027770OtherCIGNA
CTP369898OtherOXFORD
CT060051OtherHEALTH NET
CT1255448155OtherGHMC GROUP NPI
CT001277707Medicaid
CT84010OtherAETNA
CT010027770CT01OtherBCBS & BCFP NEW BRITAIN
CT010027770CT02OtherBCBS & BCFP NEWINGTON
CT060032569OtherRAIL ROAD MEDICARE ID
CT135250OtherWELLCARE MEDICARE
CT004196095Medicaid
CT2770002OtherCONNECTICARE
CT1255448155OtherGHMC GROUP NPI
CT84010OtherAETNA
CTC01373Medicare ID - Type UnspecifiedGHMC GROUP MEDICARE ID