Provider Demographics
NPI:1922092162
Name:PEPPERMAN, ROBERT C (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:PEPPERMAN
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:860-832-4666
Mailing Address - Fax:860-348-4931
Practice Address - Street 1:73 CEDAR ST
Practice Address - Street 2:GROVE HILL MEDICAL CENTER
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1390
Practice Address - Country:US
Practice Address - Phone:860-832-4666
Practice Address - Fax:860-348-4931
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032209208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT01232209OtherCIGNA
CT250006695OtherRAIL ROAD MEDICARE
CT010032209CT02OtherBCBS & BCFP ID
CT1255448155OtherGHMC GROUP NPI
CT135468OtherWELLCARE MEDICARE
CT060071OtherHEALTH NET
CT182424OtherAETNA
CT004214425Medicaid
CT001322099Medicaid
CT03220902OtherCONNECTICARE
CTP369969OtherOXFORD
CT010032209CT02OtherBCBS & BCFP ID
CT1255448155OtherGHMC GROUP NPI
F32655Medicare UPIN