Provider Demographics
NPI:1386730661
Name:STECKLER, JEFFREY B (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:B
Last Name:STECKLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 PEARL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051
Mailing Address - Country:US
Mailing Address - Phone:860-225-3587
Mailing Address - Fax:860-229-2766
Practice Address - Street 1:35 PEARL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051
Practice Address - Country:US
Practice Address - Phone:860-225-3587
Practice Address - Fax:860-229-2766
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1159037207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1159037Medicaid
B84199Medicare UPIN
CT200000158Medicare ID - Type Unspecified