Provider Demographics
NPI:1922023829
Name:DUGAN, JENNIFER MUNEYYIRCI (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MUNEYYIRCI
Last Name:DUGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 JENSEN FARM RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06478-2724
Mailing Address - Country:US
Mailing Address - Phone:203-888-6384
Mailing Address - Fax:
Practice Address - Street 1:BRISTOL HOSPITAL
Practice Address - Street 2:BREWSTER ROAD
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06011
Practice Address - Country:US
Practice Address - Phone:860-585-3273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043282207P00000X
NY228105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2572329Medicaid
NY0405Q1Medicare ID - Type Unspecified
NYI18426Medicare UPIN