Provider Demographics
NPI:1912156597
Name:ANTHONY, PAUL ROBERT JR (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ROBERT
Last Name:ANTHONY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1000 ASYLUM AVE STE 2112
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1719
Mailing Address - Country:US
Mailing Address - Phone:860-714-5895
Mailing Address - Fax:860-714-5417
Practice Address - Street 1:1000 ASYLUM AVE STE 2112
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1719
Practice Address - Country:US
Practice Address - Phone:860-714-5895
Practice Address - Fax:860-714-5417
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT051732207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease