Provider Demographics
NPI:1932273299
Name:O'REGAN, EILEEN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:ELIZABETH
Last Name:O'REGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1781 HIGHLAND AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1254
Mailing Address - Country:US
Mailing Address - Phone:203-272-1990
Mailing Address - Fax:203-271-0668
Practice Address - Street 1:1781 HIGHLAND AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-1254
Practice Address - Country:US
Practice Address - Phone:203-272-1990
Practice Address - Fax:203-271-0668
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029098207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4564088OtherAETNA
CTP1024372OtherOXFORD
CT010029098CT01OtherBLUE SHIELD
CT0V0453OtherHEALTHNET
CT1290981Medicaid
CT212170OtherCIGNA
CT290980OtherCONNECTICARE
CT010029098CT01OtherBLUE SHIELD
CTE42809Medicare UPIN
CT110005977Medicare ID - Type Unspecified