Provider Demographics
NPI:1912906579
Name:MIHALEK, JEFFREY J (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:J
Last Name:MIHALEK
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 1:300 KENSINGTON AVE
Mailing Address - Street 2:GROVE HILL MEDICAL CENTER
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3916
Mailing Address - Country:US
Mailing Address - Phone:860-666-5111
Mailing Address - Fax:860-666-5153
Practice Address - Street 1:375 WILLARD AVE
Practice Address - Street 2:GROVE HILL MEDICAL CENTER
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2300
Practice Address - Country:US
Practice Address - Phone:860-666-5111
Practice Address - Fax:860-666-5153
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035025207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001350256Medicaid
CT01035025OtherCIGNA PROV ID
CT134928OtherWELLCARE MEDICARE
CT550419OtherAETNA PROV ID
CT010035025CT02OtherBCBS N BCFP PROV ID
CT004196095Medicaid
CTP369900OtherOXFORD PROV ID
CT060121OtherHEALTH NET PROV ID
CT1255448155OtherGHMC GRP NPI ID
CT350250OtherCONNECTICARE PROV ID
G21764Medicare UPIN
CT004196095Medicaid
CT060121OtherHEALTH NET PROV ID