Provider Demographics
NPI:1104354737
Name:FIRELY, CHRISTOPHER GERALD (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GERALD
Last Name:FIRELY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 RETREAT AVE STE 811
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2528
Practice Address - Country:US
Practice Address - Phone:860-522-5712
Practice Address - Fax:860-548-0031
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-26
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA271190207R00000X
CT76789207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine