John P Ancona, MD | |
1527 Route 12, Gales Ferry, CT 06335-1800 | |
(860) 464-7248 | |
(860) 464-0125 |
Full Name | John P Ancona |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1527 Route 12, Gales Ferry, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548359060 | NPI | - | NPPES |
041171 | Other | CONNECTICARE | |
010041171CT01 | Other | BLUE CROSS | |
01411719 | Medicaid | CT | |
041171 | Other | CIGNA | |
2V4776 | Other | HEALTHNET |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 041171 (Connecticut) | Primary |
Entity Name | Northeast Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043278351 PECOS PAC ID: 1254233836 Enrollment ID: O20040123000522 |
Mailing Address | Practice Location Address |
---|---|
John P Ancona, MD 1527 Route 12, Po Box 608, Gales Ferry, CT 06335-1800 Ph: (860) 464-7248 | John P Ancona, MD 1527 Route 12, Gales Ferry, CT 06335-1800 Ph: (860) 464-7248 |
Mark A. Rosenthal, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1527 Route 12, Box 608, Gales Ferry, CT 06335 Phone: 860-464-7248 Fax: 860-464-0125 | |
David M. Rinzler, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1527 Route 12, Gales Ferry, CT 06335 Phone: 860-464-7248 Fax: 860-464-0125 | |
Dr. Foong-yi Lin, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1527 Rt 12, Box 608, Gales Ferry, CT 06335 Phone: 860-464-7248 Fax: 860-464-0125 | |
Michelle N Watson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1527 Route 12, Gales Ferry, CT 06335 Phone: 860-464-7248 Fax: 860-464-0125 | |
Charles R Esposito, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1527 Route 12, Gales Ferry, CT 06335 Phone: 860-464-7248 Fax: 860-464-0125 | |
Phyllis A. Holtzman, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1527 Route 12, Gales Ferry, CT 06335 Phone: 860-464-7248 Fax: 860-464-0125 |