Provider Demographics
NPI:1649286543
Name:SCHLEITER, GARY (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:SCHLEITER
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 1:24 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6099
Mailing Address - Country:US
Mailing Address - Phone:203-797-7100
Mailing Address - Fax:
Practice Address - Street 1:24 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6099
Practice Address - Country:US
Practice Address - Phone:203-797-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT024247207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT711406OtherCONNECTICARE
CT773437OtherCIGNA
NY01E661OtherEMPIRE BCBS
CT041767OtherHEALTH NET
NY1526952Medicaid
CTP434402OtherOXFORD HEALTH PLANS
CT1252479Medicaid
CT125395OtherAETNA US HEALTHCARE
CT1443211OtherPRIVATE HEALTH CARE SYSTE
CT711406OtherCONNECTICARE