Provider Demographics
NPI:1922258532
Name:DUFFY, PATRICK III (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:DUFFY
Suffix:III
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 1:111 FOUNDERS PLZ STE 400
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-3240
Mailing Address - Country:US
Mailing Address - Phone:860-289-3375
Mailing Address - Fax:
Practice Address - Street 1:85 SEYMOUR ST STE 200
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5509
Practice Address - Country:US
Practice Address - Phone:860-246-6589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2579082085R0202X
390200000X
CT525992085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program