Provider Demographics
NPI:1023234176
Name:DUNLOP, JOHN
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:DUNLOP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81A BEACON ST.
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851
Mailing Address - Country:US
Mailing Address - Phone:203-853-8377
Mailing Address - Fax:
Practice Address - Street 1:166 NORTH ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-1118
Practice Address - Country:US
Practice Address - Phone:203-324-5219
Practice Address - Fax:203-324-1304
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000050237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004014635Medicaid