Provider Demographics
NPI:1336178920
Name:PECHER, STEFANA M (MD)
Entity type:Individual
Prefix:DR
First Name:STEFANA
Middle Name:M
Last Name:PECHER
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:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:NORTH STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06359-0417
Mailing Address - Country:US
Mailing Address - Phone:860-535-4600
Mailing Address - Fax:860-535-4605
Practice Address - Street 1:391 NORWICH WESTERLY RD
Practice Address - Street 2:
Practice Address - City:NORTH STONINGTON
Practice Address - State:CT
Practice Address - Zip Code:06359-9992
Practice Address - Country:US
Practice Address - Phone:860-535-4600
Practice Address - Fax:860-535-4605
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT046790207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010046790CT01OtherANTHEM
I57269Medicare UPIN
CT010046790CT01OtherANTHEM
RI007060568Medicare PIN