Provider Demographics
NPI:1770587123
Name:PINKE, JAMES R (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:PINKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9 COTS ST
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-3866
Mailing Address - Country:US
Mailing Address - Phone:203-924-8800
Mailing Address - Fax:203-924-0388
Practice Address - Street 1:9 COTS ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3866
Practice Address - Country:US
Practice Address - Phone:203-924-8800
Practice Address - Fax:203-924-0388
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001236991Medicaid