Provider Demographics
NPI:1346240769
Name:FERRARO-BORGIDA, MELISSA J (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:J
Last Name:FERRARO-BORGIDA
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 1:100 RETREAT AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-2528
Mailing Address - Country:US
Mailing Address - Phone:860-522-5712
Mailing Address - Fax:860-520-4270
Practice Address - Street 1:100 RETREAT AVE
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:860-520-4270
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035180207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010035180CT01OtherANTHEM BC/BS ID#
CTP12038323OtherMULTIPLAN ID#
CTP2003061OtherOXFORD ID#
CT001351808Medicaid
CT0351800446OtherCONNECTICARE ID#
CT24569OtherHEALTH NEW ENGLAND ID#
CT2133813002OtherCIGNA HEALTHPLAN ID#
CT2135563OtherAETNA HEALTH ID#
CTOV5249OtherHEALTHNET ID#
CTG36832Medicare UPIN
CT001351808Medicaid