Provider Demographics
NPI:1134205719
Name:FICARA, ROBERT J (PA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:FICARA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 33440
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06150-3440
Mailing Address - Country:US
Mailing Address - Phone:860-522-7181
Mailing Address - Fax:860-278-3357
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 325
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-522-7181
Practice Address - Fax:860-278-3357
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT000018363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT290001368CT01OtherANTHEM BLUECROSS
CTOV7275OtherHEALTHNET
CTP2626688OtherOXFORD HEALTHPLAN
CT142300OtherCONNECTICARE
CT061028513OtherCIGNA HEALTHPLAN
CT290001368CT01OtherBLUECAREFAMILY PLAN
CT30005220OtherRAILROAD MEDICARE
CT061028513OtherCIGNA HEALTHPLAN
CT142300OtherCONNECTICARE