66
NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number 1093830762 ABBOTT JOHN 1315 ROBERTS ST CAMDEN SC 29020-3737 800-633-2243 1023130705 ABBOTT STEVEN 1733 STORRS RD STORRS CT 06268-1247 860-429-2051 1851591820 ABDALLAH CHADI 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016 1609296292 ABDUL KARIM YASMINE 300 GEORGE STREET YALE PSYCHIATRY NEW HAVEN CT 06510-3220 203-785-2095 1104850171 ABEYTA ROBERTO 140 ACADEMY ST PRESQUE ISLE ME 04769-3102 623-580-6309 1720194764 ABRAMSON ANNEMARIE 3600 EAST MAIN ST. WATERBURY CT 06705-3851 203-596-0406 1881005874 ABREU KATHRYN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055 1639166531 ACEVEDOSEGUI MIGUEL 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055 1740532761 ACHILDIEV TATIANA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152 1386669661 ACOSTA TAPIA HECTOR 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055 1861557837 ADAMS BRYAN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055 1992789416 ADAMS MILTON 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7089 1477748341 ADAMS SARAH 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677 1326035221 ADEWALE ADEMOLA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055 1386631745 ADLER ARLENE CHILDREN''S & WOMENS PHYSICIAN 19 BRADHURST AVE., STE.1400 HAWTHORNE NY 10532-2144 914-922-2241 1194806067 ADLER DARRYL 4422 3RD AVE BRONX NY 10457-2545 623-241-8350 1508894676 ADLER MARY 701 ENFIELD STREET ENFIELD CT 06082-2961 860-741-6572 1497937486 AGAG RICHARD 30 SHELBURN RD STAMFORD CT 06902-9314 203-276-7058 1447326871 AGGARWAL AMITA 322 MAIN ST PORTLAND CT 06480-1512 860-342-3303 1609974047 AGOSTIN DOMINICK 15 OLD RIDGEFIELD ROAD WILTON CT 06897-3013 203-762-9907 1295938793 AGRESTA JOHN 100 PARK STREET GLENS FALLS NY 12801-4413 518-926-5109 1023216280 AGUIRE ESTHER 75 SEMINARY HILL RD. CARMEL NY 10512-1921 845-225-3400 1023055506 AHMADIAN FERESHTEH 111 BEACH ROAD 3RD FLOOR FAIRFIELD CT 06824-6668 203-255-2340 1124333125 AHMED MOGHEES 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5000 1609074897 AHMED SHAHID 100 PARK STREET GLENS FALLS NY 12801-4413 518-926-5109 1639211931 AHUJA AJAY 825 HIGH RIDGE RD STAMFORD CT 06905-1904 203-322-3700 1144531666 AJDINOVICH JOSEPH 31 RIVER RD COS COB CT 06807-2152 203-863-2003 1558467266 AJJAGOTTU VIJAYA 555 WILLARD AVE NEWINGTON CT 06111-2631 860-666-6951 1891128146 ALBANO VICTORIA 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537 1891866059 ALCANTARA CADILLO DELLY 555 WILLARD AVENUE NEWINGTON CT 06111-2631 203-932-5711 1104204734 ALDERSON MARK 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348 1023032752 ALEXANDER HENRY 22 SOUTH GREENE STREET BALTIMORE MD 21201-1544 623-582-2141 1346361284 ALEXANDER ROBERT 928 FARMINGTON AVENUE WEST HARTFORD CT 06107-2227 860-233-7514 1558467027 ALEXIADES MICHAEL 535 EAST 70TH STREET NEW YORK NY 10021-4823 646-797-8471 1215230248 ALFONSI AMBROSE 61 GLENN DRIVE SOUTHINGTON CT 06489-4006 860-628-4460 1700197076 ALLCORN MCKAILA 111 BREWSTER ST PAWTUCKET RI 02860-4474 401-273-2919 1003934282 ALLEN CHRISTOPHER 95 HARBOR RD SUITE 955 SOUTHPORT CT 06890-3306 203-838-1678 1669457735 ALLEN REBECCA 101 DUDLEY STREET PROVIDENCE RI 02905-1464 401-273-0641 1497870273 ALLIGER JASON 1389 WEST MAIN ST SUITE 208 WATERBURY CT 06708-3115 203-757-1287 1932258373 ALMEIDA ALICIA 305 CHURCH ST SUITE 3 NAUGATUCK CT 06770-2836 203-729-5741 1902985344 ALONSO NOEL 201 EAST SAMPLE ROAD POMPANO BEACH FL 33064-3502 623-580-6309 1497923296 ALPIN JULIA 455 TOLL GATE RD WARWICK RI 02886-2759 401-273-0641 1609133578 ALRABADI LEINA 20 YORK STREET YNHH DEPT OF PEDIATRIC GI NEW HAVEN CT 06510-3220 203-688-9503 1821087073 ALSALMAN IHSAN 636 DEL PRADO BLVD CAPE CORAL FL 33990-2695 800-645-3055 1578815957 ALSAMMAN OMAR 100 MCGREGOR STREET MANCHESTER NH 03102-3730 603-314-4771 HUSKY Health Connecticut Page 1 of 66 8/17/2017 6:15:10 AM OPR Provider Listing (Ordering/Prescribing/Referring)

OPR Provider Listing (Ordering/Prescribing/Referring)

Embed Size (px)

Citation preview

Page 1: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1093830762 ABBOTT JOHN 1315 ROBERTS ST CAMDEN SC 29020-3737 800-633-2243

1023130705 ABBOTT STEVEN 1733 STORRS RD STORRS CT 06268-1247 860-429-2051

1851591820 ABDALLAH CHADI 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016

1609296292 ABDUL KARIM YASMINE 300 GEORGE STREET YALE PSYCHIATRY NEW HAVEN CT 06510-3220 203-785-2095

1104850171 ABEYTA ROBERTO 140 ACADEMY ST PRESQUE ISLE ME 04769-3102 623-580-6309

1720194764 ABRAMSON ANNEMARIE 3600 EAST MAIN ST. WATERBURY CT 06705-3851 203-596-0406

1881005874 ABREU KATHRYN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1639166531 ACEVEDOSEGUI MIGUEL 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1740532761 ACHILDIEV TATIANA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1386669661 ACOSTA TAPIA HECTOR 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1861557837 ADAMS BRYAN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1992789416 ADAMS MILTON 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7089

1477748341 ADAMS SARAH 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1326035221 ADEWALE ADEMOLA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1386631745 ADLER ARLENE CHILDREN''S & WOMENS PHYSICIAN 19 BRADHURST AVE., STE.1400 HAWTHORNE NY 10532-2144 914-922-2241

1194806067 ADLER DARRYL 4422 3RD AVE BRONX NY 10457-2545 623-241-8350

1508894676 ADLER MARY 701 ENFIELD STREET ENFIELD CT 06082-2961 860-741-6572

1497937486 AGAG RICHARD 30 SHELBURN RD STAMFORD CT 06902-9314 203-276-7058

1447326871 AGGARWAL AMITA 322 MAIN ST PORTLAND CT 06480-1512 860-342-3303

1609974047 AGOSTIN DOMINICK 15 OLD RIDGEFIELD ROAD WILTON CT 06897-3013 203-762-9907

1295938793 AGRESTA JOHN 100 PARK STREET GLENS FALLS NY 12801-4413 518-926-5109

1023216280 AGUIRE ESTHER 75 SEMINARY HILL RD. CARMEL NY 10512-1921 845-225-3400

1023055506 AHMADIAN FERESHTEH 111 BEACH ROAD 3RD FLOOR FAIRFIELD CT 06824-6668 203-255-2340

1124333125 AHMED MOGHEES 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5000

1609074897 AHMED SHAHID 100 PARK STREET GLENS FALLS NY 12801-4413 518-926-5109

1639211931 AHUJA AJAY 825 HIGH RIDGE RD STAMFORD CT 06905-1904 203-322-3700

1144531666 AJDINOVICH JOSEPH 31 RIVER RD COS COB CT 06807-2152 203-863-2003

1558467266 AJJAGOTTU VIJAYA 555 WILLARD AVE NEWINGTON CT 06111-2631 860-666-6951

1891128146 ALBANO VICTORIA 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1891866059 ALCANTARA CADILLO DELLY 555 WILLARD AVENUE NEWINGTON CT 06111-2631 203-932-5711

1104204734 ALDERSON MARK 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1023032752 ALEXANDER HENRY 22 SOUTH GREENE STREET BALTIMORE MD 21201-1544 623-582-2141

1346361284 ALEXANDER ROBERT 928 FARMINGTON AVENUE WEST HARTFORD CT 06107-2227 860-233-7514

1558467027 ALEXIADES MICHAEL 535 EAST 70TH STREET NEW YORK NY 10021-4823 646-797-8471

1215230248 ALFONSI AMBROSE 61 GLENN DRIVE SOUTHINGTON CT 06489-4006 860-628-4460

1700197076 ALLCORN MCKAILA 111 BREWSTER ST PAWTUCKET RI 02860-4474 401-273-2919

1003934282 ALLEN CHRISTOPHER 95 HARBOR RD SUITE 955 SOUTHPORT CT 06890-3306 203-838-1678

1669457735 ALLEN REBECCA 101 DUDLEY STREET PROVIDENCE RI 02905-1464 401-273-0641

1497870273 ALLIGER JASON 1389 WEST MAIN ST SUITE 208 WATERBURY CT 06708-3115 203-757-1287

1932258373 ALMEIDA ALICIA 305 CHURCH ST SUITE 3 NAUGATUCK CT 06770-2836 203-729-5741

1902985344 ALONSO NOEL 201 EAST SAMPLE ROAD POMPANO BEACH FL 33064-3502 623-580-6309

1497923296 ALPIN JULIA 455 TOLL GATE RD WARWICK RI 02886-2759 401-273-0641

1609133578 ALRABADI LEINA 20 YORK STREET YNHH DEPT OF PEDIATRIC GI NEW HAVEN CT 06510-3220 203-688-9503

1821087073 ALSALMAN IHSAN 636 DEL PRADO BLVD CAPE CORAL FL 33990-2695 800-645-3055

1578815957 ALSAMMAN OMAR 100 MCGREGOR STREET MANCHESTER NH 03102-3730 603-314-4771

HUSKY Health Connecticut Page 1 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 2: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1679537450 ALTEMUS MARGARET 950 CAMPBELL AVE BUILDING 2, ROOM 7-165 WEST HAVEN CT 06516-2770 646-209-6277

1295736833 ALTMAN ROBIN CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 2400 HAWTHORNE NY 10532-2144 914-922-2241

1336201300 ALTORELLI ALPHONSE 125 NEW MILFORD TURNPIKE NEW PRESTON CT 06777-1703 860-868-7318

1972700987 ALTSHUL VICTOR 400 PROSPECT STREET NEW HAVEN CT 06511-2181 203-787-4442

1841244399 ALVERSON BRIAN 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-7396

1417499906 ALVES CAITLIN 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-441-6767

1215974993 ALYEA EDWIN 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1144531518 AMAECHINA NNAMDI 363 HIGHLAND AVE FALL RIVER MA 02720-3703 508-973-3584

1952322802 AMANULLAH SIRAJ 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1386933216 AMAZAN-RODNEY GERLY 400 CAPITAL BLVD MC DIAGNOSTIC OF CT PC ROCKY HILL CT 06067-3576 415-547-5151

1942363189 AMBLE PAUL SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5000

1932368362 AMBROSE MARIA 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-6000

1629467873 AMES JESSICA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 774-443-7552

1053571844 AMESQUITA MICHAEL 1001 SAM PERRY BLVD FREDERICKSBURG VA 22401-4453 800-645-3055

1285626077 AMIN NIKHIL CHILDREN''S & WOMAN''S PHYSICI 19 BRADHURST AVE. STE 1400 HAWTHORNE NY 10532-2144 914-922-2241

1689666976 AMLER ROBERT CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 2400 HAWTHORNE NY 10532-2144 914-922-2241

1316032295 AMMERMAN DONALD 84 HOSPITAL AVENUE DANBURY CT 06810-6047 203-792-0400

1093997579 AMPONSAH DANIEL 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1073589578 AMREIN PHILIP 100 BLOSSOM ST BOSTON MA 02114-2696 617-724-3456

1023228327 AMSEL HAROLD 6 GLEN COVE DRIVE ROCKPORT ME 04856-4240 800-645-3055

1164598322 AMSTER SUSAN 1563 POST ROAD EAST WESTPORT CT 06880-5602 203-319-3939

1174751101 ANDERSON ASHLEIGH 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-8160

1003839291 ANDERSON ELIZABETH 67 SAND PIT ROAD DANBURY CT 06810-4032 203-743-7246

1841390036 ANDERSON LARRY 950 CAMPBELL AVE WEST HAVEN CT 06516-2700 203-932-5711

1700869831 ANDERSON RICHARD 50 STANIFORD ST 2ND FLOOR BOSTON MA 02114-2517 617-724-6960

1841631488 ANGEVINE PATRICIA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1356698567 ANIKANOVA YULIYA CHILDREN'S & WOMAN'S PHYSICI 130 GRAND ST. CROTON ON HUDSON NY 10520-2307 914-922-2241

1861430332 ANKER ANTHONY 1001 SAM PERRY BLVD FREDERICKSBURG VA 22401-4453 800-645-3055

1861469249 ANTIN JOSEPH DFCI 450 BROOKLINE AVE BOSTON MA 02215-5450 617-632-2525

1851474670 ANUNCIADO ALMA CONNECTICUT VALLEY HOSPITAL 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5000

1811354897 APHOLT MARY 725 NORTH STREET PITTSFIELD MA 01201-4019 413-447-2752

1306918651 APPEL GERALD 622 WEST 168TH STREET PH-4 ROOM 476 NEW YORK NY 10032-3270 212-305-5020

1356392203 APPLEGATE TODD 5 PEQUOT PARK RD., SUITE 201A WESTBROOK CT 06498-2856 860-391-8068

1215343926 AQUILINA STEFANIE 332 SUFFIELD ST AGAWAM MA 01001-2111 413-786-0077

1497076947 ARAYA SOLEDAD 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5000

1992744668 ARAYATA RICARDO 26 BURLING LANE 2ND FLOOR NEW ROCHELLE NY 10801-5626 914-235-1888

1811916257 ARCIERO THOMAS 1127 W MAIN STREET WATERBURY CT 06708-2765 203-754-2225

1649318585 ARDEN-CORDONE MARY 30 SHELBURNE RD STAMFORD CT 06902-9317 203-276-7058

1073921847 AREY KATIE 759 CHESTNUT STREET BAYSTATE EMERGENCY MEDICINE SPRINGFIELD MA 01199-1619 413-794-3233

1053434134 ARGENZIO DONNA CHILDREN'S & WOMAN'S PHYSICI 266 NORTH STREET STE. A NEWBURGH NY 12550-3131 914-922-2241

1528029790 ARIAS ALBERT 21 HAZEL TERRACE SUITE B WOODBRIDGE CT 06525-2209 860-558-2273

1184755670 ARIAS JANELLE 915 RIVER ROAD MIDDLETOWN CT 06457-3921 860-704-4126

1114300498 ARIAS-MAGALLONA SARAH 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1497815419 ARMSTRONG KELLY 50 CHERRY STREET MILFORD CT 06460-4050 203-783-9632

HUSKY Health Connecticut Page 2 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 3: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1679764773 ARNOLD DANIEL 433 WEST MAIN STREET HYANNIS MA 02601-3644 508-364-7522

1396039111 AROKE EDWIN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1194767681 ASAAD GHAZI 72 NORTH STREET DANBURY CT 06810-5648 203-748-1200

1770546525 ASANTE NELSON 1800 MULBERRY STREET SCRANTON PA 18510-6800 570-214-9907

1205087608 ASARE JOHN 119 BELMONT STREET UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01605-2903 508-334-8515

1205155827 ASARE MARIETTE 20 YORK STREET YNHH DEPT OF TRANSFUSION MEDIC NEW HAVEN CT 06510-3220 203-688-9503

1598104903 ASHFAQ HERA 230 S. FRONTAGE ROAD YALE CHILD STUDY CENTER NEW HAVEN CT 06519-1124 203-737-7129

1225321375 ASSELIN NICHOLAS 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1740265727 ATHANASIAN EDWARD 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1255349205 ATKINS STEPHEN 1635 CENTRAL AVENUE BRIDGEPORT CT 06610-2717 203-551-7464

1538391842 ATTMORE SUSAN 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-372-0078

1851722797 AUGUSTINE ANNIE 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-372-0078

1326184060 AVVOCATO PARTRICIA CHILDREN'S & WOMAN'S PHYSICI 222 WESTCHESTER AVE STE. 202 WHITE PLAINS NY 10604-2926 914-922-2241

1407041692 AYORA PAOLA 300 GEORGE ST YALE DEPT OF PSYCHIATRY NEW HAVEN CT 06511-6624 203-785-2095

1487774931 AYRE MARY 682 PROSPECT AVE HARTFORD CT 06105-4238 860-233-1141

1013975945 AYRES ROGER 177 POST ROAD WEST SUITE #5 WESTPORT CT 06880-4652 203-341-0706

1396885646 AZEEM MUHAMMAD 915 RIVER ROAD MIDDLETOWN CT 06457-2797 860-704-4000

1609061415 AZZI JAMIL 55 FRUIT ST GRAY BIGELOW 1003 BOSTON MA 02114-2696 617-726-5050

1225357601 BACKER KATHY 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1174595847 BACKMAN KENNETH 55 WALLS DRIVE STE. 405 FAIRFIELD CT 06824-5163 203-259-7070

1730443508 BACKSTROM IAN 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1699986828 BAGINSKI ROBERT 455 TOLL GATE RD WARWICK RI 02886-9252 401-273-0641

1306951694 BAILEY RONALD 5 SOUTH MAIN ST BRANFORD CT 06405-3800 203-488-1428

1134125834 BAIN LAURIE 357 HARTFORD TURNPIKE VERNON CT 06066-4800 860-871-9441

1184782013 BAKER C BRUCE SILVER STREEET BOX 351 MIDDLETOWN, CT 06457-7023 860-262-5358

1982853529 BAKER JOANNE 55 FRUIT ST BOSTON MA 02114-2696 617-726-8071

1407828296 BAKER WILLIAM ONE BOSTON MEDICAL CENTER PL. BOSTON MA 02118-2908 617-414-5481

1467555714 BALASURIYAR SARAVANA 1000 SILVER STREET BOX 351 MIDDLETOWN CT 06457-7023 860-262-5868

1841433364 BALDASSARRI STEPHEN 20 YORK STREET, CB-2041 NEW HAVEN CT 06510-3220 203-688-1734

1639187206 BALDWIN BARBARA CHILDREN''S & WOMENS PHYSICIAN 266 NORTH STREET, SUITE # A NEWBURGH NY 12550-3131 845-565-5437

1184727752 BALLA ROBERT 928 FARMINGTON AVENUE WEST HARTFORD CT 06107-1929 860-233-2322

1821089558 BALLEN KAREN 100 BLOSSOM ST E00-1-118 BOSTON MA 02114-2606 617-724-1124

1235235144 BALLINGER LAUREN 100 MAPLE AVE SUITE 2 GREAT BARRINGTON MA 01230-1963 413-499-4850

1265599583 BALTER ANDREW 234 CHURCH STREET SUITE 1201 NEW HAVEN CT 06510-1881 203-787-5938

1023163953 BANCROFT HARTLEY CHILDREN'S & WOMAN'S PHYSICI 400 MIDWAY PARK DR. MIDDLETOWN NY 10940-2656 914-922-2241

1063495562 BANERJI ALEENA 55 FRUIT ST COX 2 BOSTON MA 02114-2696 617-726-3850

1831164672 BANIKAZEMI MARYAM CHILDREN''S & WOMENS PHYSICIAN 503 GRASSLANDS RD VALHALLA NY 10595-1503 914-922-2241

1740320266 BANIUKIEWICZ ANDREA 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1912218918 BANKI ALI 15 CONCORD STREET GLASTONBURY CT 06033-2135 860-659-2779

1962527580 BANKOVA LORA 450 BROOKLINE AVENUE DANA FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1912942350 BANQUET AGNES CHILDREN''S & WOMAN''S PHYSICI 19 BRADHURST AVE. STE 1400 HAWTHORNE NY 10532-2144 914-922-2241

1033177936 BANSAL RAJ 305 BOSTON AVE STRATFORD CT 06614-5214 203-384-3377

1619111366 BANTZ SELENE 6 DEVINE ST 2ND FL NORTH HAVEN CT 06473-2195 203-287-6200

HUSKY Health Connecticut Page 3 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 4: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1043427925 BANWELL LANCE 387 MAIN STREET SOUTH WOODBURY CT 06798-2608 203-263-5300

1669769550 BARASZ JONAH 546 S BROAD ST SUITE 3A MERIDEN CT 06450-1034 203-630-1312

1215154117 BARBERIE MICHAEL 4 BERKSHIRE BLVD BETHEL CT 06801-1001 203-826-3142

1063868099 BARBOZA JEWEL 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1871762740 BARCROFT KEVIN 250 PLEASANT ST EMERGENCY DEPT CONCORD NH 03301-7539 603-227-7000

1477531218 BARD ADAM 2150 BLACK ROCK TURNPIKE SUITE 301 FAIRFIELD CT 06825-3239 203-384-2227

1306847397 BARENFELD HOWARD CHILDREN'S & WOMAN'S PHYSICI 91 LAKES RD MONROE NY 10950-2694 914-922-2241

1093891368 BARIBAULT HEATHER CHILDREN''S & WOMENS PHYSICIAN 255 LAFAYETTE AVE. SUFFERN NY 10901-4812 914-922-2241

1467497404 BARKSDALE ROBERT 1906 BELLEVIEW AVE ROANOKE VA 24014-1838 800-645-3055

1467603456 BARNES CHRISTOPHER 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1972601862 BARONE LUCIANO CHILDREN'S & WOMAN'S PHYSICI 10 RONALD REAGAN BLVD. WARWICK NY 10990-4104 914-922-2241

1336188127 BARR MATTHEW 2876 MAIN STREET STRATFORD CT 06614-4984 203-696-6125

1487897716 BARRETT LAUREL 1 GENERAL STREET LAWRENCE MA 01841-2961 978-683-4000

1194841379 BARRO JENNIFER 500 WEST PUTNAM AVE SUITE 100 GREENWICH CT 06830-6086 203-863-2908

1386089100 BARTKOVA NATALIA 999 SUMMER ST SUITE 300 STAMFORD CT 06905-5577 203-359-6979

1558462366 BARTON JANET 75 SEMINARYHILL RD. CARMEL NY 10512-1921 845-225-3400

1871592600 BARTON JEROME 40 CROSS STREET SUITE 300 NORWALK CT 06851-4661 203-845-2995

1154683399 BARTONE ROSE CHILDREN'S & WOMENS PHYSICIAN 19 BRADHURST AVE STE 1400 HAWTHOTNE NY 10532-2144 914-493-7997

1982600300 BARWICK MORVEN 555 WILLARD AVE. NEWINGTON CT 06111-2631 860-666-6951

1497868053 BASH JEFFREY 410 SAYBROOK ROAD SUITE 100 MIDDLETOWN CT 06457-4444 860-685-8950

1528026192 BASTARDI HEATHER 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1740452002 BASTERRECHEA HUGO 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1235128968 BATHERSON BRIAN 2 HANKS HILL RD STORRS-MANSFIELD CT 06268-2213 860-429-8280

1275574238 BATSON RAMON 67 SAND PIT ROAD SUITE 208 DANBURY CT 06810-4032 203-853-0003

1649214727 BAUER JAMES 40 MAIN ST. NORTH WOODBURY CT 06798-2966 203-263-4402

1518239581 BAUMGARTNER JACQUELINE 111 SALEM TURNPIKE SUITE 7 NORWICH CT 06360-3442 860-859-2262

1568551927 BAZOS ANDREW 226 WHITE STREET DANBURY CT 06810-6814 203-797-1500

1447212816 BEAUDOIN DONALD 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1265448203 BECK RICHARD 58 DIVISION ST DANBURY CT 06810-7753 203-743-4834

1659570182 BECKER MARGARET 950 CAMPBELL AVE WEST HAVEN CT 06516-2770 203-932-5711

1154427656 BECKER WILLIAM 950 CAMPBELL AVENUE MAILSTOP 151B WEST HAVEN CT 06516-2770 203-932-5711

1528136413 BEEBER STUART CHILDREN''S & WOMAN''S PHYSICI 175 KING ST CHAPPAQUA NY 10514-3494 914-922-2241

1700120268 BEGIN MONICA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1700985694 BEGUE CARMEN 200 HENRY CLAY AVE. NEW ORLEANS LA 70118-5720 623-241-8333

1497739916 BEHAR DAVID 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7087

1336185768 BEHRENDS ROBERT 60 WESTWOOD AVENUE SUITE 210 WATERBURY CT 06708-2460 203-597-0633

1558593442 BEKAL KARTHIK 95 SCOVILL ST. WATERBURY CT 06706-1735 203-465-5292

1609193440 BELKIND GERSON JAIME 55 FRUIT ST YAW 6B BOSTON MA 02114-2696 617-726-8705

1588823165 BELLAPIANTA JOSEPH 49 LAKE AVENUE SUITE 205 BELLAPIANTA ORTHOPAEDICS & SPO GREENWICH CT 06830-4501 855-777-1056

1447407960 BELLAPIANTA KAREN 49 LAKE AVENUE GREENWICH CT 06830-4501 203-869-0177

1780021253 BELLINGER PAIGE 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-372-0078

1124462726 BELLMUNT MOLINS JOAQUIN 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5915

1992755987 BELMAN ALEC 29 LEWIS STREET GREAT BARRINGTON MA 01230-1713 413-881-5427

1396767448 BENDER STUART 761 MAIN AVE SUITE 102 NORWALK CT 06851-0001 860-282-4133

HUSKY Health Connecticut Page 4 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 5: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1437197753 BENDER SUZANNE 53 LANGLEY ROAD SUITE 380B NEWTON MA 02459-1913 617-795-0492

1205028214 BENDOR DANIEL 567 VAUXHALL STREET EXT STE 32 WATERFORD CT 06385-4358 860-442-8033

1720218670 BENIYAMINOV YANNA CHILDREN'S & WOMAN'S PHYSICI 4350 VAN CORTLANDT PARK EAST BRONX NY 10470-1875 914-922-2241

1477525392 BENJAMIN JONATHAN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1922085885 BENJAMIN TRACY 40 HART STREET NEW BRITAIN CT 06052-1743 860-225-1227

1427046671 BENN JASON 3401 W. GORE BLVD LAWTON OK 73505-6300 800-645-3055

1205816634 BENNETT MARY 26 QUEEN STREET WORCESTER MA 01610-2473 508-334-6556

1326073420 BENNETT MICHAEL 241 PERKINS ST. B 801 JAMAICA PLAIN MA 02130-4010 617-738-9204

1396724563 BENNETT MICHAEL 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1558523142 BENSON CEDRIC 435 LEWIS AVENUE MERIDEN CT 06451-2101 203-284-1340

1407084544 BERENBERG THOMAS 1201 WEST MAIN STREET WATERBURY CT 06708-3105 203-573-4803

1063491751 BERGER LONNIE 712 S CASCADE STREET FERGUS FALLS MN 56537-2913 800-645-3055

1174731202 BERGER SHANA 1000 SILVER STREET - BOX 351 MIDDLETOWN CT 06457-7023 860-262-5000

1841355377 BERGHERR THERESA 357 WHITNEY AVE SUITE 204 NEW HAVEN CT 06511-2364 203-562-6400

1437276987 BERKSON ALAN 431 NEW HAVEN AVE MILFORD CT 06460-1448 203-877-5106

1265409726 BERLAND ROBERT 100 WELLS ST SUITE 1B HARTFORD CT 06103-2920 860-278-8937

1043505449 BERMAN DAVID 3401 N BROAD ST PHILADELPHIA PA 19140-5103 215-707-1429

1295783546 BERMAN MARVIN 363 HIGHLAND AVE FALL RIVER MA 02720-3703 508-973-3584

1477766749 BERNABA AMIR 455 TOLL GATE ROAD WARWICK RI 02866-9997 401-273-0641

1538149463 BERNBACH MARC 171 GRANDVIEW AVENUE SUITE 104 WATERBURY CT 06708-2524 203-753-2048

1164711479 BERROCAL JULIAN 20 YORK STREET YNHH TOMPKINS 2 RM 226 NEW HAVEN CT 06510-3220 203-688-4242

1407247752 BERTA GABRIELLA 75 SEMINARY HILL RD. CARMEL NY 10512-1921 845-225-3400

1508935024 BERTUCH ELIZABETH 1236 MAIN ST SUITE 202A HOLYOKE MA 01040-2955 413-532-6777

1306831391 BERV DOUGLAS 60 WASHINGTON AVENUE SUITE 102 HAMDEN CT 06518-3271 203-407-6444

1194945634 BEVERIDGE PHYLLIS 915 RIVER ROAD MIDDLETOWN CT 06457-3921 860-704-4097

1255449997 BEYER BARBARA CHILDREN'S & WOMAN'S PHYSICI 10 WEATHERVANE DR. WASHINGTONVILLE NY 10992-2242 914-922-2241

1114014891 BEZDICKOVA MARTINA CHILDREN'S & WOMAN'S PHYSICI 10 WEATHERVANE DR. WASHINGTONVILLE NY 10992-2242 914-922-2241

1083957187 BHALLA ISH 20 YORK STREET YNHH DEPT OF PSYCHIATRY NEW HAVEN CT 06510-3220 203-688-9503

1386701639 BHALODIYA VIPULKUMA 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1790003051 BIALECK SUZANNE ONE BROOKDALE PLAZA BROOKLYN NY 11212-3198 800-432-4334

1730231705 BIANCHI CHRISTOPHER 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1326371261 BIELAWSKI MARK 555 WILLARD AVENUE NEWINGTON CT 06111-4272 860-667-6894

1275626889 BIERLY JOHN 625 HOPMEADOW STREET SIMSBURY CT 06070-2449 860-658-5552

1841328473 BIERMAN FREDERICK CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE STE 1400 HAWTHORNE NY 10532-2144 914-922-2241

1881668101 BILCHIK TANYA 144 MAIN STREET SUITE D EAST HARTFORD CT 06118-3239 860-895-3133

1679558944 BILSKY MARK 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1992795207 BINDER WILLIAM 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1982016366 BINNALL BRIAN 759 CHESTNUT STREET S4604 SPRINGFIELD MA 01199-1619 413-794-5550

1689661597 BIRENBAUM DALE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1518037860 BIRKBECK HELEN 100 BILTON RD SOMERS CT 06071-1059 860-814-4868

1407815681 BISHOP KENNETH 44201 DEQUINDRE ROAD TROY MI 48085-1117 248-585-8271

1154427490 BISNAUTH RAJESH CHILDREN'S & WOMAN'S PHYSICI 266 WHITE PLAINS RD EASTCHESTER NY 10709-4429 914-922-2241

1376630756 BITTMAN BETSY 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1487880084 BIVENS MATTHEW 101 PAGE STREET NEW BEDFORD MA 02740-3464 508-973-3584

1063571560 BIVONA JAMES 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

HUSKY Health Connecticut Page 5 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 6: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1780838631 BLACK TREVOR 100 PARK STREET GLENS FALLS NY 12801-4413 801-259-1900

1194752576 BLACKMAN LAUREL BOX 351 - PAGE HALL - 2ND FL 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1861931008 BLACKMER ALEKSANDRA 759 CHESTNUT STREET SPRINGFIELD MA 01107-1619 413-794-3233

1841580149 BLACKWELL KATHERINE 555 WILLARD AVENUE PRIMARY MENTAL HEALTH CARE CLI NEWINGTON CT 06111-2631 860-666-6951

1124550983 BLACKWOOD TECSHANA 1 LONG WHARF DR STE 212 NEW HAVEN CT 06511-5593 203-624-4208

1467591552 BLAIR CHARLES 836 FARMINGTON AVENUE SUITE 221C WEST HARTFORD CT 06119-1505 860-523-1451

1477789402 BLAIR JORDANA 4422 3RD AVE BRONX NY 10457-2545 800-645-3055

1619030103 BLATT KENNETH 500 VINE STREET HARTFORD CT 06112-1639 860-297-0909

1679718563 BLEVINS GRAIG 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1215227467 BLOHM EIKE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1760757017 BLOND BENJAMIN 20 YORK STREET YNHH NEUROLOGY NEW HAVEN CT 06510-3220 203-688-4242

1659582419 BLOOM DAVID 1060 DAY HILL ROAD WINDSOR CT 06095-5719 860-688-5595

1760697635 BLOOM KATHERINE 55 WALLS DRIVE STE. 405 FAIRFIELD CT 06824-5163 203-259-7070

1932428059 BLOOM SCOTT 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1790720753 BLUE HOWARD 660 WINCHESTER AVENUE GROUND LEVEL NEW HAVEN CT 06511-1969 203-776-8390

1194710210 BLUM THOMAS 200 SANDY HOLLOW RD MYSTIC CT 06355-1744 860-572-0402

1154496016 BLUMENTHAL LISA 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016

1902876626 BOBROWITZ JEFFREY CHILDREN'S & WOMAN'S PHYSICI 42 SHERWOOD PL GREENWICH CT 06830-5638 914-922-2241

1750301982 BOCCIARELLI PAUL 506 CROMWELL AVE SUITE 203 ROCKY HILL CT 06067-1836 860-529-8582

1952396228 BOCHENEK JOANNA CHILDREN'S & WOMAN'S PHYSICI 400 MIDWAY PARK DR. MIDDLETOWN NY 10940-2656 914-922-2241

1811964026 BODEN SCOTT 415 SILAS DEANE HIGHWAY WETHERSFIELD CT 06109-2119 860-563-1400

1568504538 BODEY JANET 30 SHELBURN RD STAMFORD CT 06902-9314 203-276-7058

1336361849 BOGDON SANDRA 35 EAST MAIN STREET WESTPORT CT 06880-3750 203-227-4821

1619075173 BOHOMEY JEAN 500 ENTERPRISE DRIVE 500 ENTERPRISE ROCKY HILL CT 06067-3913 860-221-0799

1154656999 BOISVERT CATHY 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1669715090 BOJARSKI EMERIC 20 YORK ST YNHH TOMPKINS 2, ROOM 226 NEW HAVEN CT 06510-3220 203-688-9503

1730563354 BONAVITA TAMMI 2 MEDICAL CENTER DRIVE SUITE 308 SPRINGFIELD MA 01107-1271 413-794-7020

1063729697 BOND NESTOR 725 NORTH STREET PITTSFIELD MA 01201-4109 413-447-2752

1043387384 BOND STEVEN 34 DALE ROAD AVON CT 06001-3659 860-677-0079

1093791469 BONDARCHUK THOMAS 1084 CROMWELL AVENUE ROCKY HILL CT 06067-3445 860-780-2002

1366514549 BONHEIM NELSON 500 WEST PUTNAM AVE SUITE 100 GREENWICH CT 06830-6086 203-863-2908

1114083664 BONYAI EILEEN 501 CRESCENT ST SCSU COUNSELING CENTER EN 219 NEW HAVEN CT 06515-1355 203-392-8861

1316935034 BOOLBOL ROBERT 11 SOUTH ROAD FARMINGTON CT 06032-1943 203-743-7246

1255380259 BOREYKO CHRISTOPHER MED NOW, P.C. 1040 BARNUM AVENUE STRATFORD CT 06614-4968 203-377-5733

1770623639 BOSSIO DEBRA 100 DANBURY RD, SUITE 102 RIDGEFIELD CT 06877-4122 203-431-4443

1598830606 BOUCHEREAU CHANEL 299 CAREW STREET SUITE 226 SPRINGFIELD MA 01104-1007 413-737-9746

1376507699 BOULWARE MARY 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1568737716 BOURNIVAL NICOLE 20 YORK STREET YNHH DEPT PULMONARY & CC NEW HAVEN CT 06510-3220 203-688-4242

1982638375 BOURQUE VICTORIA 55 NYE ROAD SUITE 102 GLASTONBURY CT 06033-1281 860-657-3056

1205920295 BOURQUE JR JESSE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1407870330 BOUSLOUGH DAVID 164 SUMMIT AVENUE PROVIDENCE RI 02906-2853 401-854-2504

1922267822 BOUTSIKARIS DANIEL 254 EASTON AVENUE NEW BRUNSWICK NJ 08901-1766 800-645-3055

1922095835 BOWEN AUDREY 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

HUSKY Health Connecticut Page 6 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 7: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1366439275 BOWLS BRADFORD 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1619067303 BOWMAN MELISSA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1821002973 BOYAR EVAN 201 EAST SAMPLE ROAD POMPANO BEACH FL 33064-3502 954-847-4572

1356437479 BOYER JOSE CHILDREN'S & WOMAN'S PHYSICI 266 WHITE PLAINS RD EASTCHESTER NY 10709-4429 914-922-2241

1740206309 BOYLE LISA 297 PROMENADE STREET PROVIDENCE RI 02908-5720 401-273-0641

1215068135 BOZZUTO JAMES 660 PROSPECT AVE HARTFORD CT 06105-1222 860-233-8672

1316070691 BRACCI BRIAN 391 SHAKER ROAD ENFIELD CT 06082-2376 860-763-6580

1942279773 BRACKETT JENNIFER 55 LOCK STREET YALE HEALTH CENTER NEW HAVEN CT 06511-3603 203-432-5791

1659609584 BRADY REBECCA 170 HAZARD AVE ENFIELD CT 06082-4520 860-749-2022

1285659177 BRAGDON ALLEN 29 LEWIS STREET GREAT BARRINGTON MA 01230-1713 413-881-5427

1144475591 BRAHAJ ARBEN 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2770 203-932-5711

1952398877 BRAHMBHATT ALKESH 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1710049622 BRAIER FLORENCIA CHILDREN'S & WOMAN'S PHYSICI 115 MAIN ST TUCKAHOE NY 10707-2948 914-922-2241

1730183146 BRAMWIT STEVEN 125 STRAWBERRY HILL AVENUE SUITE 103 STAMFORD CT 06902-2536 203-348-7797

1144257288 BRAND MICHAEL 226 WHITE STREET DANBURY CT 06810-6814 203-702-6640

1588636807 BRANDEN PETER 1201 WEST MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4885

1730240839 BRAUER LEE 65 MEMORIAL ROAD SUITE 440 WEST HARTFORD CT 06107-4221 860-586-8930

1841335163 BRAUER RICHARD 49 LAKE AVENUE SUITE 205 GREENWICH CT 06830-4501 203-869-0177

1669682753 BRAUN IVY CHILDREN''S & WOMENS PHYSICIAN 2529 ROUTE 52 STE. 3 HOPEWELL JUNCTION NY 12533-3246 845-227-0123

1598109712 BRAUNGART ELIZABETH 18D LEDGEBROOK DRIVE MANSFIELD CT 06250-1694 585-729-0278

1073552865 BRAY DIANE 664 PROSPECT AVE HARTFORD CT 06105-4203 860-236-8087

1811129463 BREEN JEANNE 115 HIGHLAND AVENUE BRIDGEPORT CT 06604-3549 203-333-9175

1609967496 BREGANTE AUDREY 148 EAST AVENUE SUITE 3G NORWALK CT 06851-5727 203-838-4034

1538199898 BRENNAN ALISON 333 BORTHWICK AVE PORTSMOUTH NH 03801-4198 804-267-4364

1538117049 BRENNAN MICHAEL 140 SHERMAN ST 2ND FLOOR FAIRFIELD CT 06824-5849 203-255-6780

1710029053 BRENNOCK MARGARET 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1023488145 BRETING NICOLE 186 PROVIDENCE STREET THUNDERMIST HEALTH CENTER WEST WARWICK RI 02893-2508 401-767-4100

1962856179 BREW ODELIA 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-338-6600

1043447758 BREWER ROBERT 315 S MANNING BLVD ALBANY NY 12208-1707 623-241-8350

1457653081 BREYTMAN EDUARD 1 RIVER STREET THUNDERMIST HEALTH CENTER WAKEFIELD RI 02879-3214 401-767-4100

1184784738 BRICE CHRISTIAN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1992919104 BRICENO JOSE 1700 SOUTH TAMIAMI TRAIL SARASOTA FL 34239-3509 800-645-3055

1568783223 BRIDGE LAUREN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1720182876 BRIDGER LAURIE 55 LOCK STREET YALE HEALTH NEW HAVEN CT 06511-3603 203-432-0076

1235263369 BRIENZA REBECCA 950 CAMPBELL AVENUE MAIL CODE: 11ACS1 WEST HAVEN CT 06516-2770 203-932-5711

1518016799 BRIGGS JUDITH 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-372-0078

1063864437 BRIGGS STEPHANY 134 THURBERS AVENUE PROVIDENCE RI 02905-0241 401-273-0641

1154677938 BRINSON WILLIAM 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1851350417 BRIONES MARIA 344 E MAIN ST STE 303 MOUNT KISCO NY 10549-3027 914-597-2317

1093073959 BRODSKY NINA 1 PARK STREET YNHH CHILDREN'S HOSPITAL NEW HAVEN CT 06510-3220 203-688-4242

1548212251 BROMBERG WARREN MOUNT KISCO MEDICAL GROUP PC 110 S. BEDFORD ROAD MOUNT KISCO NY 10549-3446 914-241-1050

1053689489 BRONSTEIN WANDA 357 HARTFORD TPKE VERNON CT 06066-4800 860-871-9441

1629400635 BROOKS JOEL 20 YORK STREET NEW HAVEN CT 06519-3220 203-688-9503

1578956405 BROOKS SARAH 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-224-5443

1396752424 BROUGH ALEXANDER ONE GENERAL STREET LAWRENCE MA 01841-2961 978-683-4000

HUSKY Health Connecticut Page 7 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 8: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1689659435 BROWN CAROL 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1497882211 BROWN DEBRA 915 RIVER ROAD MIDDLETOWN CT 06457-3921 860-704-4045

1437318631 BROWN GABRIEL 185 ROUTE 312 MOUNT KISCO MEDICAL GROUP PC BREWSTER NY 10509-2337 845-278-7000

1003032467 BROWN HARRY TEMENOS INSTITUTE 29 EAST MAIN ST. WESTPORT CT 06880-3749 203-227-4388

1417053620 BROWN WILFRED 530 MIDDLEBURY ROAD SUITE 201A MIDDLEBURY CT 06762-2546 203-758-2564

1083957633 BRUCE NEIL 300 GEORGE STREET, SUITE 901 NEW HAVEN CT 06511-6617 203-785-2095

1427074194 BRUCH JR FREDERICK ONE VERNEY DRIVE GREENFIELD NH 03047-5000 603-547-3311

1376770727 BRUNEAU HEATHER 455 TOLL GATE RD WARWICK RI 02886-2759 401-737-7000

1366791790 BRYAN ROBERT 3401 N BROAD STREET PHILADELPHIA PA 19140-5103 215-707-1429

1033296223 BRYON LORI 170 HAZARD AVE ENFIELD CT 06082-4520 860-749-2022

1659453041 BUCHANAN ANNE 1 RIVER STREET THUNDERMIST HEALTH CENTE WAKEFIELD RI 02879-3214 401-767-4100

1578506846 BUCKLEY ELISE 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1386063972 BUDDE KRISTIN 300 GEORGE STREET, STE 901 YALE PSYCHIATRY NEW HAVEN CT 06511-6624 203-785-2095

1023227956 BUFFKIN KIMBERLY 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1134158041 BUGAI TERRENCE 1312 WEST MAIN STREET WATERBURY CT 06708-3121 215-442-5029

1639145139 BUKHARI NAYER 153 MAIN STREET SUITE 9 MANCHESTER CT 06042-3130 860-646-2345

1023193547 BULL PETER 435 LEWIS AVENUE MERIDEN CT 06451-2101 203-284-1340

1396882312 BURDICK THERESA 75 SEMINARY HILL RD. CARMEL NY 10512-1921 845-225-3400

1053412106 BURGESS STEPHEN 759 CHESTNUT STREET SPRINGFIELD MA 01199-1619 413-794-3233

1275636847 BURKARD DAVID 928 FARMINGTON AVENUE WEST HARTFORD CT 06107-1929 860-233-2322

1447353016 BURKE EMA 928 FARMINGTON AVENUE WEST HARTFORD CT 06107-1929 860-233-2322

1790745057 BURKE ROBERT 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1528017969 BURNS FRANK 1700 SOUTH TAMIAMI TRAIL SARASOTA FL 34239-3509 800-645-3055

1861488868 BURRISFISH JAMEY 11 DOG HILL ROAD DAYVILLE CT 06241-2106 860-779-0321

1245307438 BURSTEIN DAVID 34 DALE ROAD SUITE 208 AVON CT 06001-3659 860-677-0079

1982766119 BURSTEIN ROBERT 15 MORGAN FARMS DRIVE SUITE 3 SOUTH WINDSOR CT 06074-1372 860-644-4741

1811986177 BURTON JAY 701 ENFIELD STREET ENFIELD CT 06082-2961 860-741-6572

1386959336 BUSH ARA 195 EASTERN BLVD SUITE 200 GLASTONBURY CT 06033-9998 860-781-6294

1801987151 BUSH ERIC 780 MAIN ST., STE.1 GREAT BARRINGTON MA 01230-2180 413-528-2418

1669459178 BUTLER LAURIE 2377 BOSTON ROAD SUITE 200 WILBRAHAM MA 01095-1254 413-596-5550

1881094936 BUTLER NICOLE 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-224-5438

1922136191 BUTTERFASS ANDREW 670 STONELEIGH AVE CARMEL NY 10512-3997 800-633-2243

1003893132 BUTTNER WILLIAM 697 POMFRET STREET QUIET CORNER FAMILY PRACTICE POMFRET CT 06258-0011 860-315-5400

1457446874 BYLAN TRACY 410 SAYBROOK ROAD MIDDLETOWN CT 06457-4780 860-685-8950

1356788764 BYRON KELSEY 100 HOSPITAL ROAD LEOMINSTER MA 01453-2253 508-334-8152

1851524953 CABALLERO JAIME 7050 GALL BLVD ZEPHYRHILLS FL 33541-1347 800-645-3055

1073539730 CABATU AMABELJ 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1174548168 CACCIATORE MICHAEL 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1972851558 CADOO KAREN 500 WESTCHESTER AVE WEST HARRISON NY 10604-3200 646-227-3813

1205995123 CAHILL STEPHEN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1770990962 CALDER KATHERINE 759 CHESTNUT STREET SPRINGFIELD MA 01199-1619 413-797-3233

1144343328 CALLAHAN ANN 10 CORBIN DR. SUITE 4 DARIEN CT 06820-5403 203-655-0002

1205904307 CALLAHAN JOANNE 4 MIDLAND ROAD WATERBURY CT 06705-3412 203-743-4698

1992899215 CALLIGARIS ROSEMARY CHILDREN'S & WOMAN'S PHYSICI 266 WHITE PLAINS RD EASTCHESTER NY 10709-4429 914-922-2241

1659437580 CALLIS DOUGLAS 515 OLD TOLL ROAD MADISON CT 06443-1836 203-421-4100

HUSKY Health Connecticut Page 8 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 9: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1568404242 CAMERON IAN 2174 MAIN ST GLASTONBURY CT 06033-2206 860-657-3602

1942469119 CAMERON KATHERINE 2344 BOSTON ROAD WILBRAHAM MA 01095-1104 413-370-8800

1366475469 CAMERON SANDRA 2150 MAIN STREET SPRINGFIELD MA 01104-3300 860-741-6572

1942310040 CAMP FRANCIS 359 FARMINGTON AVENUE PLAINVILLE CT 06062-1343 860-747-5761

1770807679 CAMPBELL ANDRENE 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1568436830 CAMPBELL DEBRA 320 POMFRET STREET PUTNAM CT 06260-0901 860-928-6541

1164496824 CAMPBELL FAYOMA 1461 SOUTH BRITAIN ROAD SOUTHBURY TRAINING SCHOOL SOUTHBURY CT 06488-0901 860-309-6314

1265541056 CAMPO ALFONSE 1275 SUMMER ST SU. 107 STAMFORD CT 06905-5315 203-354-3974

1205226321 CAMPOS NICOLE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1912966052 CAMPOS SUSANA 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1184801458 CANDELARIA EFRAN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1235334913 CANTATOREFRANCIS JULIE 148 EAST AVE. SUITE 3B NORWALK CT 06851-9993 203-538-5682

1336464734 CANTILLO EVELYN 101 DUDLEY STREET PROVIDENCE RI 02905-1417 401-273-0641

1629082540 CANTNER IRA 97 ELM STREET OLD SAYBROOK CT 06475-4144 860-388-4439

1871507798 CANTNER MATTHEW 97 ELM STREET OLD SAYBROOK CT 06475-4144 860-388-4439

1760484554 CANTOR LILIAH CHILDREN''S & WOMAN''S PHYSICI 755 N BROADWAY STE. 540 SLEEPY HOLLOW NY 10591-1076 914-922-2241

1013961325 CAPITE DAVID 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1053679431 CAPOBIANCO ALESSANDRA 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1710122890 CAPOZZI DONALD 100 OXFORD RD OXFORD CT 06478-1724 203-888-6060

1497817464 CAPOZZI KENNETH 158 WATERBURY RD PROSPECT CT 06712-0021 203-758-4224

1700264827 CAPPADONA PATRICIA 26 QUEEN STREET 4TH FLOOR WORCESTER MA 01610-2473 508-334-6556

1679548697 CAPUANO MICHAEL 455 TOLL GATE ROAD WARWICK RI 02886-2759 401-273-0641

1609165257 CAPURSO NOAH 20 YORK STREET NEW HAVEN CT 06510-3202 203-688-9503

1801007166 CARABALLO DAMIAN 2600 BRUCE B DOWNS BLVD WESLEY CHAPEL FL 33544-9207 800-645-3055

1295829521 CARACENI LESLIE 12 LIBRARY STREET FRAMINGHAM MA 01701-9998 508-202-9050

1861592156 CARAYANNOPOULOS ALEXIOS 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-3777

1881600880 CARBONE JOSEPH 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1265440598 CARCIERI DAVID 1637 MINERAL SPRING AVENUE SUITE 211 NORTH PROVIDENCE RI 02904-4042 401-353-0757

1588632541 CARDENAS ALFONSO 455 TOLLGATE ROAD WARWICK RI 02886-2759 401-273-0641

1780948596 CARDENAS CELINA 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-338-6600

1346207602 CAREN CHELSY 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1043415995 CAREY PATRICIA NORWALK HEALTH DEPARTMENT 137 EAST AVE NORWALK CT 06851-5702 203-854-7973

1336214469 CARILLO DOMINICK 100 PARK STREET GLENS FALLS NY 12801-4413 518-926-5109

1558489161 CARIUS KATHLEEN 1129 STRATFORD AVE MILFORD CT 06460-3142 203-375-8050

1699726554 CARLESI VINCENT 999 SUMMER STREET SUITE 304 STAMFORD CT 06905-5513 203-325-5700

1689866618 CARLSON CHRISTINA 58 MISSIONARY RD CROMWELL CT 06416-2134 860-632-8703

1063599637 CARLSON JUDITH 95 THOMASTON AVENUE WATERBURY CT 06702-5501 203-805-6414

1780853788 CARLUCCI HARLE 370 LINWOOD STREET NEW BRITAIN CT 06052-1949 860-832-5742

1033378435 CARON DAVID 24 PUTNAM PIKE DAYVILLE CT 06241-1608 860-779-1230

1033199286 CARON PHILIP 500 WESTCHESTER AVE WEST HARRISON NY 10604-3200 646-227-3813

1538184999 CARPENTER ROBERT 1635 NORTH LOOP W HOUSTON TX 77008-1532 801-256-1900

1851587208 CARR KATHLEEN 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1194756379 CARR STEPHEN 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1922087014 CARRALERO CESAR 6401 N FEDERAL HWY FORT LAUDERDALE FL 33308-1427 623-580-6309

1376557199 CARROLL CAROLYN 6 BUSINESS PARK DR. SUITE 204 BRANFORD CT 06405-2924 203-538-5682

HUSKY Health Connecticut Page 9 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 10: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1104805431 CARROLL LASHUN 1 RIVER STREET THUNDERMIST HEALTH CENTER WAKEFIELD RI 02879-3214 401-767-4100

1679022875 CARTER DAVID 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-8152

1497158521 CARTER HEATHER 400 CAPITOL BLVD ROCKY HILL CT 06067-3913 860-986-3289

1508027244 CARTER ROBERT 725 NORTH STREET PITTSFIELD MA 01201-4019 413-447-2752

1760484513 CARTWRIGHT LOWE MD NADINE 555 WILLARD AVENUE NEWINGTON CT 06111-2631 866-808-7921

1942373113 CASS ALISON 8 WEST END AVE OLD GREENWICH CT 06870-1642 203-637-3212

1679823116 CASSIDY JAMES 151 BROAD STREET MIDDLETOWN CT 06457-3327 860-889-8346

1912198920 CASSON ANNE 1275 YORK AVE PDH NEW YORK NY 10065-6007 212-639-5948

1609118421 CASTELLONE JOANN 191 ALBANY TPKE CANTON CT 06019-2554 860-693-0887

1316977242 CASTIGLIONE JR FRANK 1844 WHITNEY AVENUE HAMDEN CT 06517-1400 203-281-5445

1265460547 CASTILLO SERGIO 1101 NOTT ST SCHENECTADY NY 12308-2425 801-256-1900

1619973690 CATAPANO-FRIEDMAN LISA 357 SHIELDS DRIVE BENNINGTON VT 05201-9810 802-442-3757

1962476218 CATTANEO COLLEEN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1285791244 CAVOLI ROBERT 65 MAIN ST. TERRYVILLE CT 06786-5103 860-589-9001

1144588567 CEMALOVIC NAIL 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1750563938 CERRA MARY 55 FRUIT ST BOSTON MA 02114-2696 617-643-0335

1851493852 CHA BRUCE 60 WASHINGTON AVE STE 202 HAMDEN CT 06518-3272 203-281-6574

1205857117 CHACHAJ JERZY 115 SPENCER STREET WINSTED CT 06098-1141 860-738-6985

1174630651 CHACHO KAROL 4699 MAIN STREET SUITE 210 BRIDGEPORT CT 06606-1830 203-372-5282

1790844926 CHACKO ELSAMMA 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1588047955 CHAHBANDAR OMAR 1 RIVER STREET THUNDERMIST HEALTH CENTER WAKEFIELD RI 02879-3214 401-767-4100

1316267305 CHAI PETER 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1871576736 CHALEBY KUTAIBA 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-8160

1487614277 CHAMBERLAIN RICHARD 4250 E CAMELBACK RD STE K105 PHOENIX AZ 85018-8374 602-559-9310

1710044847 CHAMBERLIN DOUGLAS 49 WELLES ST STE 202 GLASTONBURY CT 06033-4205 860-659-4010

1568427243 CHAN ALEXANDER 13-17 ELIZABETH STREET SUITE 409 NEW YORK NY 10013-4903 212-334-3999

1891782686 CHAN KAHANG 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1265658116 CHAN PHILIP 164 SUMMIT AVENUE PROVIDENCE RI 02906-2853 401-444-6779

1043598956 CHAN WAIYAN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1356689319 CHAND SUDHAM 250 PLEASANT STREET CONCORD NH 03301-2598 603-227-7000

1104053842 CHANG AMY 100 MLK JR BLVD STE 300 WORCESTER MA 01608-1209 508-755-4861

1205825197 CHANG JAIME 15 PARKMAN ST WANG 108 BOSTON MA 02114-3117 617-726-2707

1720385727 CHANNELL VICTORIA 40 CROSS STREET SUITE 300 NORWALK CT 06851-4661 203-845-2995

1003158460 CHAO CHRISTINA 761 MAIN AVE SUITE 102 NORWALK CT 06851-0001 860-282-4133

1386636645 CHAO CHUN-PENG CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 1400 HAWTHORNE NY 10532-2140 914-922-2241

1548571813 CHAPMAN KATIE 111 BREWSTER ST PAWTUCKET RI 02860-4474 401-273-0641

1174566806 CHAPMAN LAURA 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1063746592 CHAPMAN NICOLE 455 TOLLGATE ROAD WARWICK RI 02886-2759 401-273-0641

1932312709 CHARNEY HOWARD 2559 DIXWELL AVENUE HAMDEN CT 06514-1809 203-248-0072

1194987842 CHAUDHARY NIDA 5750 POST ROAD EAST GREENWICH RI 02818-7685 401-273-0641

1700068103 CHAVEL SEVERINE 1290 SUMMER ST STE 3600 STAMFORD CT 06905-5325 203-325-3576

1619921129 CHAWLA ANJULIKA 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-8219

1497932867 CHEN JARA 20 YORK STREET, CB-2041 NEW HAVEN CT 06510-3220 203-688-1734

1700101219 CHEN MICHAEL 263 FARMINGTON AVE CHILD & ADOLESCENT PSYCHIATRY FARMINGTON CT 06030-1410 860-679-2730

HUSKY Health Connecticut Page 10 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 11: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1477006120 CHEN YAN 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-441-6767

1891021788 CHENAIL SARAH 725 NORTH STREET PITTSFIELD MA 01201-4124 413-447-2752

1598753980 CHENG CHRISTINE 555 WILLARD AVENUE NEWINGTON CT 06111-4272 203-932-5711

1033215256 CHERVIN BRADFORD 2600 POST ROAD SOUTHPORT CT 06890-1258 203-256-3338

1821099235 CHESIR JOSHUA CHILDREN''S & WOMAN''S PHYSICI 337 N. MAIN ST. STE 4 NEW CITY NY 10956-4318 914-922-2241

1003982091 CHESS CYRUS 153 EAST AVE NORWALK CT 06851-5711 203-853-1191

1538439484 CHILDS DENIS 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1689724734 CHILLAR PANKAJ 4077 5TH AVE SAN DIEGO CA 92103-2105 800-645-3055

1790074185 CHING SANDY 10 UNION SQUARE EAST 4K NEW YORK NY 10003-3314 646-602-8030

1922168913 CHO CAROLINE CHILDREN'S & WOMAN'S PHYSICI 150 WHITE PLAINS RD. STE 101 TARRYTOWN NY 10591-5521 914-922-2241

1952744930 CHO YOUNGSUN 300 COLLEGE STREET YNHH - PSYCHIATRY NEW HAVEN CT 06511-6624 203-785-2095

1881959229 CHOCKALINGAM RAVIKUMAR 189 STORRS ROAD MANSFIELD CT 06250-1683 860-456-1311

1316914070 CHODOSH JAMES 243 CHARLES STREET BOSTON MA 02114-3002 617-804-4789

1619964400 CHOI SEAN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1780091660 CHOI SUN-JUNG 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1043576952 CHOKSHI SAURIN 20 YORK STREET YNHH DEPT OF ONCOLOGY NEW HAVEN CT 06510-3220 203-688-9503

1669577953 CHOMIAK MARY ANN 11 SOUTH ROAD SUITE 250 FARMINGTON CT 06032-1943 203-743-7246

1396713905 CHOU NORMAN 455 TOLLGATE ROAD WARWICK RI 02886-2759 401-273-0641

1073677209 CHOUEIRI TONI 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1255430625 CHRISTENSEN STACY 201 WEST MAIN ST NIANTIC CT 06357-7504 860-679-5523

1922136886 CHRISTIAN LAWRENCE 625 HOPMEADOW STREET SIMSBURY CT 06070-2449 860-658-1991

1508266750 CHRISTIAN MICHAEL 625 HOPMEADOW ST CENTER FOR DENTAL EXCELLENCE SIMSBURY CT 06070-2449 860-658-1991

1770810319 CHU JEFFREY 1060 DAY HILL ROAD WINDSOR CT 06095-5719 860-688-5595

1669468153 CHUKWUMA SAMUEL 201 EAST SAMPLE ROAD POMPANO BEACH FL 33064-3502 623-580-6309

1811911753 CHUN THOMAS 593 EDDY STREET CLAVERICK 2 PROVIDENCE RI 02903-4923 401-854-2504

1700044468 CHUNG ERICA 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-7396

1518992874 CHUNG JIN 555 WILLARD AVENUE NEWINGTON CT 06111-2631 203-932-5711

1992723282 CIANCIMINO DAVID 4697 MAIN STREET BRIDGEPORT CT 06606-1869 203-372-5695

1740390228 CIARALLO LYDIA 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1649428319 CIARCIA JAMES 388 EAST MAIN ST SUITE 3 BRANFORD CT 06405-2914 203-480-5300

1710211370 CICHON DEANNA 130 DIVISION ST DERBY CT 06418-1326 616-464-0027

1063473312 CIMINO PETER 1300 POST RD SUITE 202 FAIRFIELD CT 06824-6038 203-255-8827

1801842505 CIMINO WILLIAM 52 BEACH RD STE 207 FAIRFIELD CT 06824-6017 203-255-7000

1508253584 CIMOCH CHRISTINE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1194064055 CINNANTE KARMA CHILDREN'S & WOMENS PHYSICIAN 115 MAIN STREET, STE.301 TUCKAHOE NY 10707-2949 914-771-7070

1720020597 CIOFFI PATRICIA 555 WILLARD AVENUE NEWINGTON CT 06111-2600 860-666-6951

1770570558 CISNEROS LEONARDO 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1790895795 CIZEK SUSAN 181 WHITE ST HEALTH SERVICE DANBURY CT 06810-6828 203-837-8593

1467408534 CLARICK CAROLYN 90 S. BEDFORD ROAD MOUNT KISCO MEDICAL GROUP PCV MOUNT KISCO NY 10549-3412 914-242-1370

1033200506 CLARK ANDREW 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7089

1326387846 CLARK ANN MARIE 91 WATER STREET MILFORD MA 01757-3005 508-334-8152

1740501311 CLARK BRIAN 300 CEDAR ST TAC-441 SOUTH NEW HAVEN CT 06519-1612 203-785-3207

1528392313 CLARK CHRISTOPHER 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

HUSKY Health Connecticut Page 11 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 12: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1124098876 CLARK HELEN 725 NORTH STREET PITTSFIELD MA 01201-4109 413-447-2752

1275923781 CLARK JONATHAN 60 HOSPITAL ROAD LEOMINSTER MA 01453-2205 508-793-6348

1235115213 CLARK MARK CMRC ONE VERNEY DRIVE GREENFIELD NH 03047-5000 603-547-3311

1831132406 CLARK TIFFANY 29 LEWIS STREET GREAT BARRINGTON MA 01230-1713 413-881-5427

1548205800 CLARKOWSKI BRIAN 1455 ST FRANCIS AVE SHAKOPEE MN 55379-3374 612-262-3851

1144218223 CLAUNCH ALAN 636 DEL PRADO BLVD CAPE CORAL FL 33990-2695 800-645-3055

1457575052 CLAUSS KELLY 55 PECK ROAD TORRINGTON CT 06790-6106 860-482-8588

1437273216 CLAY LEE 34 SYCAMORE AVENUE SUITE 2A LITTLE SILVER NJ 07739-1228 732-747-9310

1922062397 CLEARY JAMES 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5450 617-632-5917

1578760310 CLEARY MCGIVEN MEGAN 300 LONGWOOD AVE BOSTON MA 02115-5724 860-456-1279

1093702870 CLEVELAND RENEE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1083153969 CLIFFORD MATTHEW 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1891774188 CLODFELTER CHARLES 8745 N WICKHAM RD MELBOURNE FL 32940-5997 623-582-2141

1518023522 CLOUTIER MICHELLE 282 WASHINGTON ST HARTFORD CT 06106-3322 860-837-5323

1083638928 CLYNE BRIAN 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1962405100 COCHRAN ELAINE 9000 ROCKVILLE PIKE BUILDING 10, CRC 6-5940 BETHESDA MD 20892-1612 301-496-2718

1093914715 COCHRAN THOMAS 580 COURT STREET THE CHESHIRE MEDICAL CENTER KEENE NH 03431-1718 603-354-6534

1164744553 COCKS ANN 400 CAPITAL BLVD. 3RD FLOOR ROCKY HILL CT 06067-3576 860-227-0791

1437310182 COCOLA ELIZABETH UNIVERSITY OF SAINT JOSEPH 1678 ASYLUM AVE WEST HARTFORD CT 06117-2791 860-231-5530

1679557276 CODY III HIRAM 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1932121365 COE MARY 57 NORTH ST STE 203 DANBURY CT 06810-5627 203-791-9777

1750480224 COFFEY MARGARET 291 WHITNEY AVE #202 NEW HAVEN CT 06511-3724 203-980-5544

1942231782 COFFEY TOM 15 CORPORATE DRIVE TRUMBULL CT 06611-1351 203-452-7081

1942237847 COGHLIN DANIEL 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-7396

1326138785 COHEN CYNTHIA CHILDREN''S & WOMAN''S PHYSICI 422 WESTERN HWY TAPPAN NY 10983-1311 914-922-2241

1710074075 COHEN DANIEL 171 RAMAPO RD STE 4 GARNERVILLE NY 10923-1564 845-947-1772

1881768158 COHEN DAVID 622 WEST 168TH STREET PH-4 ROOM 124 NEW YORK NY 10032-3720 212-305-5020

1245523463 COHEN ERIC 2 DUDLEY STREET SUITE 200 PROVIDENCE RI 02905-3248 401-626-3872

1629005350 COHEN ISAAC 888 WHITE PLAINS RD TRUMBULL CT 06611-4552 203-268-2882

1851488191 COHEN IVAN 1305 POST ROAD SUITE 310 FAIRFIELD CT 06824-6018 203-259-7709

1801093943 COHEN JONATHAN 19801 OBSERVATION DR GERMANTOWN MD 20876-4070 800-645-3055

1033294269 COHEN KENNETH 22 UPPER MAIN STREET BOX 634 SHARON CT 06069-0634 917-597-7890

1962604785 COHN JAMIESON 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1780774414 COHN-HAFT HERA 10 NORTH MAIN ST WEST HARTFORD CT 06107-1941 860-521-5575

1073789830 COLAN MIGUEL 360 MAIN STREET SUITE 3 HARTFORD CT 06106-1880 860-241-0448

1356302434 COLE DAVID 3460 S. PIONEER PKWY WEST VALLEY CITY UT 84120-2049 801-256-1900

1285629568 COLE J 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1477617843 COLE KAREN CHILDREN'S & WOMENS PHYSICIAN 1075 CENTRAL PARK AVE SCARSDALE NY 10583-3242 914-472-4300

1780043539 COLEMAN MAIREAD 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1811151707 COLEMAN NICOLE 455 TOLL GATE RD KENT HOSPITAL WARWICK RI 02886-2759 401-273-0641

1013008044 COLEMAN TANA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1598055139 COLIN ASHLEIGH 230 SOUTH FRONTAGE ROAD NEW HAVEN CT 06519-1124 203-785-2540

1649620501 COLLERAN PETER 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-441-6767

1497099519 COLON ROMAN WANDA 60 HOSPITAL ROAD LEOMINSTER MA 01453-2205 508-793-6348

HUSKY Health Connecticut Page 12 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 13: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1285650622 COLWELL SHARON 1450 CHAPEL ST NEW HAVEN CT 06511-4405 203-789-3000

1164675005 COLYER EMILY 455 TOLL GATE RD WARWICK RI 02886-2759 401-737-7000

1427208255 COMERFORD HEATHERANNE 326 WASHINGTON STREET WILLIAM W BACKUS HOSPITAL NORWICH CT 06360-2740 860-889-8331

1427168129 CONBOY KEVIN 38 LAKE AVENUE GREENWICH CT 06830-4515 845-639-0007

1174585723 CONCILIO GERARDO 132 OLD RIVER RD LINCOLN RI 02865-1397 401-334-2949

1023113818 CONDON DEIDRE 172 MT. PLEASANT RD. NEWTOWN CT 06470-1443 203-426-0045

1104379783 CONLAN BRAEDEN 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-443-7552

1871548099 CONLEY AMY 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1346649019 CONNOR JACQUELINE 2150 MAIN STREET SPRINGFIELD MA 01104-3566 860-741-6572

1538209556 CONNORS RICHARD 1 PERRYRIDGE ROAD SUITE 2 GREENWICH CT 06830-4648 203-622-0808

1003085150 CONOVER BRIAN 1000 SILVER STREET BOX 351 MIDDLETOWN CT 06457-7023 860-262-5000

1265434526 CONSTANTINOU EUGENE 555 WILLARD AVE NEWINGTON CT 06111-2631 860-666-6951

1275625790 CONWAY ELIZABETH 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-748-5721

1720372196 CONWAY ERIN 223 E 34TH ST NEW YORK NY 10016-4852 646-558-0803

1275972937 COOMBS PETER 110 MOUNTAIN RD SUFFIELD CT 06078-2083 860-668-0283

1255792479 COOPER DANIELL 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0791

1346287406 COOPER HERBERT 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1659486173 COOPER STEPHEN 666 GLENBROOK ROAD STAMFORD CT 06906-1420 203-406-0554

1447373642 COOPERMAN SHEILA 55 WEST MAIN ST SUITE 410 WATERBURY CT 06702-5501 203-805-6414

1548371800 COPANS STUART 455 SOUTH STREET BARRE MA 01005-0304 978-355-4541

1396706230 COPE JENNIFER 1200 EAST RIDGEWOOD AVE RIDGEWOOD NJ 07450-3957 201-444-0868

1598763997 COPPOLA PAUL 145 DURHAM RD. STE 1 OAK PARK PROF.OFFICES MADISON CT 06443-2656 203-245-8035

1962852814 COPPOLA STEPHEN 1692 EAST MAIN ST TORRINGTON CT 06790-3519 315-454-6000

1952700726 CORCORAN KAREN 152 WEST STREET CCBH DANBURY CT 06810-6361 203-791-5155

1619967114 CORDES DAVID 145 HAZARD AVE ENFIELD CT 06082-4521 860-749-1909

1982984316 COREY JORDICE 528 WASHINGTON HIGHWAY MORRISVILLE VT 05661-8973 508-482-9600

1124243134 CORL KEITH 593 EDDY STREET CLAVERICK 2 PROVIDENCE RI 02903-4923 401-854-2504

1083083638 CORNELL KIMBERLY 71 WALL STREET ARIA DERMSPA MADISON CT 06443-3121 203-865-6143

1598805277 CORREALE DANA 677 SOUTH MAIN STREET CHESHIRE CT 06410-3158 203-250-7577

1366569220 CORREIA MANUEL 363 HIGHLAND AVE FALL RIVER MA 02720-3703 508-973-3584

1720173099 CORRIVEAU JENNIFER 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1588651376 CORTES BELEN ERNESTO 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1366609257 CORTEZZO DONNAMARIA DIV. OF NEONATOLOGY 282 WASHINGTON ST HARTFORD CT 06106-3322 860-545-8950

1174555437 CORWIN JOHN 17 WOODLAND RD MADISON CT 06443-2342 203-245-3929

1669441499 COSTABILE DAVID CHILDREN'S & WOMAN'S PHYSICIAN 755 N BROADWAY STE. 500 SLEEPY HOLLOW NY 10591-1077 914-922-2241

1891740189 COSTEA GEANINA 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-4515

1821432956 COTE ANIK 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1215191283 COTE JILL 300 LONGWOOD AVE BOSTON MA 02115-5724 617-355-8537

1134288376 COTTERELL MARK 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5000

1801846324 COUGHLIN KEVIN 294 NORTH MAIN STREET EAST LONGMEADOW MA 01106-1718 413-519-9421

1962441022 COUSIN JEFFREY 5 PERRYRIDGE ROAD GREENWICH HOSPITAL GREENWICH CT 06830-4608 914-984-2552

1174714117 COVEY CINTHIA 1201 WEST MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4885

1972866622 CRAFORD JOHN PAUL 101 PAGE STREET NEW BEDFORD MA 02740-3464 508-973-3584

1104086925 CRAGO AIMEE 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

HUSKY Health Connecticut Page 13 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 14: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1841467503 CRAIG ELIZABETH 5 DURHAM ROAD UNIT 1-4 GUILFORD CT 06437-2076 203-458-4444

1265845135 CRANFORD MELISSA 300 GEORGE STREET YALE PSYCHIATRY, SUITE 901 NEW HAVEN CT 06511-0666 203-785-2095

1730117110 CRAWFORD WILLIAM 250 PLEASANT STREET CONCORD NH 03301-2598 603-227-7000

1225036528 CRISCENZO DONNA 199 GOOSE LANE GUILFORD CT 06437-2115 203-458-2888

1568606960 CRISTESCU GEORGE 455 TOLL GATE RD JOHNSON BUILDING WARWICK RI 02886-2791 401-273-0641

1851623219 CROAD MELISSA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1548297658 CROMWELL HOLLY 455 TOLL GATE ROAD WARWICK RI 02886-2759 401-921-7566

1417126251 CRONIN BETH 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1790070530 CRONIN KELLY 30 MILESTONE ROAD DANBURY CT 06810-5103 203-456-8353

1992892319 CROSSON CHRISTINE 263 MAIN STREET SUITE 304 OLD SAYBROOK CT 06475-2529 860-395-6671

1114221462 CROW THERESA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1528039195 CROWE JOHN 6 GREENWICH OFFICE PARK GREENWICH CT 06831-5100 203-869-1145

1962791772 CUA BENNETT 20 YORK STREET YNHH DEPT CARDIOLOGY NEW HAVEN CT 06510-3220 203-688-9503

1467656330 CUCCHI ERIC 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 508-797-5512

1942285242 CUCKA MICHAEL 641 CLARK AVE STE B BRISTOL CT 06010-4068 860-582-6603

1477867331 CUDAHY PATRICK 300 CEDAR STREET SUITE S169 NEW HAVEN CT 06519-1612 203-785-7571

1154524767 CUELLO ADOREE 9 VICTORIA LANE WESTPORT CT 06880-2155 203-227-2556

1437548997 CUMMINS ANDREW 8 LINCOLN ST. WESTPORT CT 06880-4201 203-916-4600

1255363651 CUNANAN ANTONIO 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1457803298 CUNNINGHAM LINDA 75 SEMINARY HILL RD. CARMEL NY 10512-1921 845-225-3400

1134321722 CUNNINGHAM MATTHEW 535 E. 70TH ST. NEW YORK NY 10021-4823 646-797-8471

1366728693 CURATO MARK 4422 3RD AVE BRONX NY 10457-2545 800-645-3055

1568698009 CURESKY KIMBERLY 1881 POST RD FAIRFIELD CT 06824-5721 203-255-1036

1033111356 CURRAN DONALD 950 CAMPBELL AVE WEST HAVEN CT 06516-2770 203-932-5711

1891087052 CURRIE MELANIE 575 BEECH STREET HOLYOKE MA 01040-2223 215-442-5031

1154610590 CURRIER MICHAEL 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-441-6767

1952565889 CURTICE WALTER 116 GRANITE STREET QUALITY MEDICINE LLC WESTERLY RI 02891-2460 401-602-7031

1457519829 CUSHING SEAN 10123 SE MARKET PORTLAND OR 97216-2532 800-633-2243

1720205313 CUTHBERTSON EMILY 3401 N BROAD ST PHILADELPHIA PA 19140-5103 215-707-1429

1285863712 CUTSHAW AARON 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1982819058 CWIK RONALD 652 BOSTON POST ROAD GUILFORD CT 06437-2719 203-459-5214

1629144886 CZUCZKA PETER 1563 POST ROAD EAST WESTPORT CT 06880-5602 203-319-3939

1417103193 D'ANGELO LOREN 300 LONGWOOD AVE BOSTON MA 02115-5724 617-355-8537

1750315610 D'ONOFRIO MARIE 64 ROBBINS STREET WATERBURY CT 06708-2613 203-573-6056

1659757227 DACUNHA MARIA 799 NEW HAVEN ROAD NAUGATUCK CT 06770-4762 919-425-1526

1639160807 DAHL DOUGLAS 15 PARKMAN ST GRB 1102 BOSTON MA 02114-3117 617-726-0875

1770591307 DAHLBERG CARL 725 NORTH STREET PITTSFIELD MA 01201-4109 413-447-2752

1811963242 DAHLE JAMES 3580 WEST 9000 SOUTH WEST JORDAN UT 84088-8812 615-467-1238

1679699136 DAHLGARD KAREN 832 TALL TIMBER RD ORANGE CT 06477-1424 203-387-8425

1639144843 DAHLSTROM GERALD 119 BELMONT STREET WORCESTER MA 01605-2903 508-334-8692

1053372862 DAHLSTROM RUTH 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1215916697 DALBAGNI GUIDO 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1669748927 DALEY JANIN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

HUSKY Health Connecticut Page 14 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 15: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1639453996 DALTON MEGHAN 300 LONGWOOD AVE BOSTON MA 02115-5724 617-355-8537

1891755211 DALUISKI AARON 535 E. 70TH ST. NEW YORK NY 10021-4823 646-797-8471

1477530665 DALY KAREN NATCHAUG HOSPITAL 189 STORRS RD. MANSFIELD CT 06250-1683 860-456-1311

1053489864 DAMAN LAUREN 100 RETREAT AVE SUITE 603 HARTFORD CT 06106-2528 860-246-3533

1457464067 DAMON EDWIN 64 PALOMBA DR ENFIELD CT 06082-3850 860-745-6248

1447250287 DAMORE MARY BETH CHILDREN'S & WOMAN'S PHYSICI 755 N BROADWAY STE. 400 SLEEPY HOLLOW NY 10591-1076 914-922-2241

1699757278 DANGELICA MICHAEL 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1528401304 DANIELS-MILLER LINDA 36 EAST MAIN STREET AVON CT 06001-3801 860-674-0333

1326444159 DANYEW JANICE 500 ENTERPRISE DRIVE ROCKY HILL CT 06067-3913 615-224-5443

1275532707 DANZA ROBERTA 204 CHERRY ST MILFORD CT 06460-3555 203-876-0545

1346506094 DAO NHU Y 1201 WEST MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4803

1386703528 DARGAN AMARJEET CONNECTICUT VALLEY 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1053764993 DARKOH ERNEST 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1346272937 DARLING ALISA 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1386717783 DARVISH AMIR 800 WASHINGTON STREET BOSTON MA 02111-1552 617-636-4721

1922037472 DAS SAUMYA 99 HIGHWAY 37 WEST TOMS RIVER NJ 08755-6498 800-645-3055

1962425009 DASCANIO JOSEPH 532 CHAPEL STREET NEW HAVEN CT 06511-6905 203-865-4286

1982961843 DATTA RAHUL 20 YORK STREET YNHH DEPT OF ALLERGY/IMMUNO NEW HAVEN CT 06510-3220 203-688-9503

1245452994 DATTILO PHILIP 2500 ROCKY MOUNTAIN AVE LOVELAND CO 80538-9004 800-645-3055

1942218540 DAVID MARIA CHILDREN'S & WOMAN'S PHYSICI 266 NORTH STREET STE A NEWBURGH NY 12550-3131 914-922-2241

1659541522 DAVIDS MATTHEW 450 BROOKLINE AVE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-3484

1780889469 DAVIDSON BRUCE 273 POST ROAD WEST WESTPORT CT 06880-4702 203-226-7788

1861854127 DAVIDSON MARA 8 LINCOLN STREET WESTPORT CT 06880-4201 203-916-4600

1396874723 DAVIES JEFFREY 340 BROAD ST TOTAL MEDICAL CARE, FLR 1 WINDSOR CT 06095-3030 860-688-8888

1497005011 DAVIS KRYSTAL 20 YORK STREET NEW HAVEN CT 06510-1111 203-688-2430

1942308945 DAVIS LAURA 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2770 203-932-5711

1215346390 DAVIS MELINDA 1040 BARNUM AVENUE MED NOW, P.C. STRATFORD CT 06614-4968 203-377-5733

1134302334 DAVIS PETER 75 EASTERN POINT RD BLDG. 97 1ST FLOOR GROTON CT 06340-0970 860-433-2070

1972587038 DAW MANJAREE 139 HAZARD AVE ENFIELD CT 06082-4583 860-253-0037

1346215019 DAY IRENE 595 W STATE STREET DOYLESTOWN PA 18901-2554 623-580-6309

1194754549 DAY SUSAN 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-4201

1619140316 DAYE MONA NATCHAUG HOSPITAL 189 STORRS RD MANSFIELD CENTER CT 06250-1683 860-456-1311

1255365458 DE ANGELIS SYDNEY 101 HOSPITAL ROAD EAST PATCHOGUE NY 11772-4870 631-654-7236

1053331462 DE ESCOBAR MARCOS 171 GRANDVIEW AVE. SUITE 101 WATERBURY CT 06708-2517 203-757-9336

1265561369 DE LA TORRE DANIEL 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1154742187 DE LEON JANICE 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0797

1902972110 DEACKOFF NANCY CAPITOL REGION MENTAL HEALTH C 500 VINE STREET HARTFORD CT 06112-1639 860-297-0999

1750601225 DEBIASI ERIN WINCHESTER CHEST CLINIC 789 HOWARD AVE NEW HAVEN CT 06519-1304 203-785-4198

1750669685 DECHON REBEKAH 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1912927781 DECUIR PETE 2150 MAIN STREET SPRINGFIELD MA 01104-3300 860-741-6572

1942378567 DEFILIPPO SALVATORE 1824 WHITNEY AVENUE HAMDEN CT 06517-1405 203-288-0338

1326350596 DEFINA VINCENT 98 ELM STREET WEST HAVEN CT 06516-6839 203-933-6974

1306913785 DEITZ JEFFREY 1261 POST ROAD SUITE 200-A FAIRFIELD CT 06824-6072 203-255-0770

1043210297 DELANEY VERONICA CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 200N HAWTHORNE NY 10532-2140 914-922-2241

1013970730 DELANO KIMBERLY 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

HUSKY Health Connecticut Page 15 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 16: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1104089523 DELAPORTA SARA 186 PROVIDENCE STREET THUNDERMIST HEALTH CENTER WEST WARWICK RI 02893-2508 401-767-4100

1093867913 DELFINI RONALD 1204 CHAPEL ST. NEW HAVEN CT 06511-4777 203-787-4770

1619990868 DELVECCHIO JOHN 75 HOLLY HILL LANE LEVEL C GREENWICH CT 06830-6098 203-863-3492

1033223219 DELVECCHIO RONALD 281 HARTFORD TPKE VERNON CT 06066-4784 860-872-6016

1588631964 DEMAC ALEX 530 MIDDLEBURY ROAD SUITE 202-B MIDDLEBURY CT 06762-2500 203-758-1817

1720211444 DEMAYO JOSEPH 56 FRANKLIN STREET WATERBURY CT 06706-1253 203-709-8864

1528439528 DEMERICH MEGAN 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1841267093 DEMETRI GEORGE DANA FARBER CANCER INSTITUTE 450 BROOKLINE AVENUE BOSTON MA 02215-5418 617-632-5917

1851679559 DEMEY ADAM 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1760405542 DEMPSEY THOMAS 163 BROADWAY ST COLCHESTER CT 06415-1022 860-228-1719

1295780500 DENEKAS ALAN 1613 OAKWOOD ST BEDFORD VA 24523-1213 800-645-3055

1609162007 DENMAN AMI 43 HIGH STREET WAREHAM MA 02571-2097 508-973-3584

1073912614 DEPINTO CASSANDRA 1275 SUMMER STREET SUITE 306 STAMFORD CT 06905-5359 203-978-5775

1295721017 DESCHAMPS PATRICIA CHILDREN'S & WOMENS PHYSICIAN 266 NORTH STREET, STE. A NEWBURGH NY 12550-3131 845-565-5737

1154617686 DESESA CHRISTOPHER 115 ELM STREET ENFIELD CT 06082-3712 860-573-7556

1992748495 DESIDERIO CARL 7600 RIVER RD NORTH BERGEN NJ 07047-6217 800-645-3055

1295984383 DESIKAN VARDHINI CHILDREN'S & WOMAN'S PHYSICI 755 N BROADWAY STE. 400 SLEEPY HOLLOW NY 10591-1076 914-922-2241

1043214604 DESPOT KATY 115 TECHNOLOGY DR, A100 TRUMBULL CT 06611-5343 203-880-5556

1356317283 DESPRES BERNARD 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1295764579 DEUTSCH JEROME 809 TURNPIKE AVENUE CLEARFIELD PA 16830-1232 814-768-2488

1063565844 DEVARAJ SHANTHI 1400 BEDFORD STREET STAMFORD CT 06905-5200 203-323-8700

1679581623 DEVINSKY ORRIN 223 EAST 34TH ST NEW YORK NY 10016-4852 646-558-0859

1427360999 DEVIVO RYAN 759 CHESTNUT STREET SPRINGFIELD MA 01199-1619 413-794-3233

1235450412 DEW DAWN 19801 OBSERVATION DR GERMANTOWN MD 20876-4070 800-645-3055

1528339934 DHROSO KAYLN 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-443-7552

1326046624 DIAMOND CHRISTOPHER CENTRAL CONNECTICUT STATE UNIV 1615 STANLEY ST NEW BRITAIN CT 06053-2490 860-832-1934

1326009473 DIAS BEATRICE 409 BANTAM ROAD, SUITE A-2 LITCHFIELD CT 06759-3200 860-361-9660

1619065786 DIAZ ESPERANZA 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1760893143 DIAZ STRANSKY ANDREA 230 S FRONTAGE RD YALE CHILD ADOLESCENT PSYCH NEW HAVEN CT 06519-1124 203-737-7129

1649627811 DIBIASIO-WHITE ERIC 759 CHESTNUT STREET SPRINGFIELD MA 01107-1619 413-794-5550

1356330344 DIEDERICH JENNIFER 218 MAIN STREET FARMINGTON CT 06032-2959 860-470-3660

1447252812 DIETTE KEVIN 88 NOBLE AVE MILFORD CT 06460-4736 203-878-3435

1386624138 DIGANGI MARY 326 NICHOLAS ROAD FITCHBURG MA 01420-1914 508-334-6556

1538576293 DIGREGORIO MIAH 85 SOUTH STREET WARE MA 01082-1625 413-967-2275

1811056054 DIKE CHARLES CONNECTICUT VALLEY BOX 351 - 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1871861625 DILLON RYAN 52 BEACH RD STE 104 FAIRFIELD CT 06824-6017 203-254-2000

1851327456 DILTS STEPHEN 1001 S. GEORGE ST. YORK PA 17403-3676 800-645-3055

1104925866 DINNEEN MARY 30 LOCUST ST NORTHAMPTON MA 01061-5001 800-432-4334

1710962709 DISA JOSEPH 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1720044753 DITTRICH FREYA 670 STONELEIGH AVE CARMEL NY 10512-3997 800-633-2243

1467826511 DIXON ANNIKA 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-441-6767

1578750808 DIXON PETER 192 WESTBROOK RD. ESSEX CT 06426-1556 860-767-1200

1194787028 DIXSON MILADY 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

HUSKY Health Connecticut Page 16 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 17: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1023140092 DOBAS DANIEL 3704 MAIN ST STRATFORD CT 06614-4227 203-377-6727

1700195807 DOCCHIO MICHAEL 6 DAVIS ROAD WEST OLD LYME CT 06371-2323 860-434-5565

1952383960 DOCTOROFF LAUREN 330 BROOKLINE AVE BOSTON MA 02215-5400 617-754-4677

1669491775 DODDAMANE SANTOSH 555 WILLARD AVE NEWINGTON CT 06111-2600 860-666-6951

1497700652 DOHERTY LISA 450 BROOKLINE AVENUE DA2116 BOSTON MA 02215-5450 617-632-5925

1093808883 DOLAN THOMAS 1160 SILAS DEANE HIGHWAY SUITE 305 WETHERSFIELD CT 06109-4330 860-529-2000

1891857553 DOLL CHERYL 500 ENTERPRISE DR ROCKY HILL CT 06067-3913 860-882-8673

1467420927 DOMINGUEZ BURNS MAYRA 1600 S. ANDREWS AVE FORT LAUDERDALE FL 33316-2510 800-633-2243

1982729174 DOMMU VERNON 195 TUNXIS HILL CUT OFF SOUTH FAIRFIELD CT 06825-4454 203-336-1275

1619196755 DONALDSON DAVID 593 EDDY STREET PROVIDENCE RI 02903-4923 401-464-9751

1417042672 DONATO-DUQUE WELDA 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7089

1649218223 DONOFRIO LISA 134 PARK STREET NEW HAVEN CT 06511-5409 203-865-6143

1184999468 DONOHUEGONZALEZ KRISTEN 2900 PURCHASE STREET PURCHASE NY 10577-2405 914-323-5245

1134194046 DONOVAN LESLIE 159 WEST PUTNAM AVENUE GREENWICH CT 06830-5329 203-869-7080

1194740399 DONSHIK PETER 47 JOLLEY DRIVE BLOOMFIELD CT 06002-3092 860-286-5448

1952326472 DORMAN ROBERT 555 WILLARD AVE NEWINGTON CT 06111-2631 860-666-6951

1053405043 DORSEY MICHAEL 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1023239555 DOS REIS ROBERTO 40 CROSS STREET SUITE 300 NORWALK CT 06851-4661 203-845-2995

1962506105 DOS SANTOS JEANNE CHILDREN'S & WOMEN'S PHYSICI 755 NORTH BROADWAY SLEEPY HOLLOW NY 10591-1076 914-366-3400

1245639871 DOS SANTOS ROBYN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6173

1518987072 DOTSON TRACE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1033443692 DOUGLAS MATTY HOLLY 23 WAUREGAN RD BROOKLYN CT 06234-1924 860-774-0876

1992750947 DOVE ERIN 1613 OAKWOOD ST BEDFORD VA 24523-1213 800-645-3055

1467667212 DOW JAMES 181 NORTH MAIN ST. WALLINGFORD CT 06492-3711 203-269-4443

1972699486 DOWNEY MEGAN 40 WRIGHT STREET PALMER MA 01069-1138 413-283-8761

1437267465 DOYLE MICHAEL 4920 MAIN STREET SUITE 301 BRIDGEPORT CT 06606-1300 203-373-1200

1881860310 DOYLE MICHAEL 22 5TH ST STE 201 STAMFORD CT 06905-5014 203-324-4747

1215993506 DOYLE THOMAS 101 PAGE STREET NEW BEDFORD MA 02740-3464 508-973-3584

1558532747 DREW SHANNON 291 WHITNEY AVE SUITE 303 NEW HAVEN CT 06511-3724 203-624-0570

1285776104 DRISCOLL WILLIAM 415 MAIN STREET WEST HAVEN CT 06516-4265 203-933-2464

1801127626 DROESCH KAREN 297 KNOLLWOOD ROAD SUITE 305 WHITE PLAINS NY 10607-1849 914-661-2030

1295826147 DROST PAUL 950 CAMPBELL AVE WEST HAVEN CT 06516-2770 203-932-5711

1154417293 DRUGGE RHETT 50 GLENBROOK ROAD UNIT 1C STAMFORD CT 06902-2914 203-324-5719

1821172073 DSOUZA DEEPAK 950 CAMPBELL AVENUE PSYCHIATRY SERVICE 116A, VACHS WEST HAVEN CT 06516-1111 203-932-5711

1124361753 DUBEY JESSE 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1972592848 DUBIN HOWARD 435 LEWIS AVENIUE MERIDEN CT 06451-2101 203-284-1340

1265591408 DUBOCZY JOHN 1000 SILVER STREET MIDDLETOWN CT 06457-7203 860-262-5000

1720095433 DUDAS BRITTANY 270 GREENWICH AVENUE GREENWICH CT 06830-6520 917-674-2545

1508006750 DUDLEY CATHERINE 759 CHESTNUT STREET SPRINGFIELD MA 01199-1619 413-794-3233

1033203914 DUDLEY JOHN 172 MOUNT PLEASANT RD NEWTOWN CT 06470-1443 203-426-0045

1578533923 DUFFY DONNA 361 MAIN STREET MANCHESTER CT 06040-4127 860-646-9929

1326109471 DUGAN SUSAN 401 WEST THAMES ST BLDG 301 NORWICH CT 06360-7167 860-859-4609

1174594279 DUKE DANIELLA 55 WILLOW ST MYSTIC CT 06355-2636 860-245-1612

1831128404 DUKES ROBERT 304 WRIGHT STREET SWEETWATER TN 37874-1181 800-645-3055

1568617918 DUNKLE LISA 12 RICHBOROUGH ROAD MADISON CT 06443-2530 203-599-6064

HUSKY Health Connecticut Page 17 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 18: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1598923948 DUNN PETER 308 E 73RD ST NEW YORK NY 10021-4433 212-517-3954

1205219482 DURAKOVIC MUSAN 736 IRVING AVENUE SYRACUSE NY 13210-1690 800-645-3055

1457649063 DURAZZO TYLER 4 CORPORATE DR. SUITE 386 SHELTON CT 06484-6211 203-538-5682

1316032063 DURFEY NICOLE 455 TOLLGATE ROAD WARWICK RI 02886-2759 401-273-0641

1255649737 DURHAM JUANITA 201 W MAIN ST. NIANTIC CT 06357-7504 860-451-3099

1356368716 DURIE CATHERINE 30 LUCUST ST NORTHAMPTON MA 01061-5001 800-432-4334

1427498120 DUSAD ASHA 263 FARMINGTON AVE FARMINGTON CT 06030-1921 860-679-4458

1851399752 DVORETZKY ISRAEL 22 WESTFIELD AVENUE ANSONIA CT 06401-1158 203-735-6144

1649291980 DWENGER RANDALL 3 BROOK STREET BOX 718 LAKEVILLE CT 06039-0718 860-435-8863

1407165780 DWIRA KOBINA 75 SEMINARY HILL RD. CARMEL NY 10512-1921 845-225-3400

1952337115 EARDLEY DANIEL 363 HIGHLAND AVE FALL RIVER MA 02720-3703 508-973-3584

1013154509 EATON MAURITA 2876 MAIN STREET STRATFORD CT 06614-4984 203-696-6125

1063583466 EDDY BRIAN 1224 FARMINGTON AVE WEST HARTFORD CT 06107-2668 860-313-0947

1902956121 EDELMANN CHRISTOPHER 42 SHERWOOD PL GREENWICH CT 06830-5638 203-869-0502

1750440699 EDMONSON DAVID ONE BLACKSTONE PLACE PROVIDENCE RI 02905-2401 401-273-0641

1689638751 EDWARDS CHRISTINE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1013973486 EDWARDS MARILEE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1518042092 EGAN KENNETH 901 ETHAN ALLEN HWY RIDGEFIELD CT 06877-2834 203-438-4111

1205898806 EGSIEKER ERIK 10123 SE MARKET PORTLAND OR 97216-2532 800-633-2243

1568411973 EHRLICH TIMOTHY 4 CORPORATE DR SHELTON CT 06484-6211 203-880-5000

1215363114 EIDT PEARSON LAUREN 151 WORCESTER ROAD BARRE MA 01005-9002 508-334-6556

1477591097 EIN ALSHAEBA SAMER 95 SCOVILL ST VA CLINIC, SECOND FLOOR WATERBURY CT 06706-1113 203-465-5292

1134210289 EINBINDER ROSLYN 60 TEMPLE STREET SUITE 4E NEW HAVEN CT 06510-2716 203-562-4088

1588629695 EINHORN LAWRENCE 535 BARNHILL DRIVE RT 473 INDIANAPOLIS IN 46202-5112 317-962-3125

1699901199 EL JAWAHRI AREEJ 55 FRUIT ST YAWKEY 9E BOSTON MA 02114-2696 617-726-5765

1518129923 ELFATAH MAHMOUD 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7089

1912136086 ELHAMAMSY SALAHELDIN 455 TOLL GATE ROAD WARWICK RI 02886-1417 401-273-0641

1194072744 ELIA MILAGROS 999 SUMMER STREET, SUITE 304 STAMFORD CT 06905-5513 203-325-5700

1063477032 ELINZANO HEINRICH 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-5435

1639333834 ELLIOT ADRIAN 29 LEWIS AVE GREAT BARRINGTON MA 01230-1713 413-881-5427

1902171341 ELLIS DANA 134 PARK STREET NEW HAVEN CT 06511-5409 203-865-6143

1336359587 ELLIS SCOTT 535 EAST 70TH ST. NEW YORK NY 10021-4823 646-797-8471

1063412518 ELLSWORTH MICHAEL 255 POMFRET ST. PUTNAM CT 06260-0456 860-928-7939

1336103167 ELMASRY WAGUIH 1962 VANDOLAH RD WAUCHULA FL 33873-8726 863-773-2857

1730150855 ELSON BARRY 395 PLEASANT ST NORTHAMPTON MA 01060-3914 413-584-7787

1043267537 ELSON JUDITH 761 MAIN AVE NORWALK CT 06851-1080 203-853-9900

1518939388 ELSON MARTIN 593 EDDY STREET PROVIDENCE RI 02903-4923 401-464-6406

1427102565 EMILIO ROBERT 111 EAST AVE., SUITE 214 NORWALK CT 06851-6851 203-866-7164

1730422734 ENGLER ZACHARY 20 YORK STREET YNHH NEW HAVEN CT 06510-3220 203-688-9503

1427040708 ENNABI KATHLEEN CHILDREN'S & WOMAN'S PHYSICI 2529 ROUTE 52-STE 3 HOPEWELL JUNCTION NY 12533-3246 914-922-2241

1376502161 ENYART THOMAS 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1083769921 ERWICH LAWRENCE 420 S. MAIN ST. CHESHIRE CT 06410-2308 203-272-7044

1831572239 ESTIS NICHOLAS 1 HOSPITAL PLAZA STAMFORD HOSPITAL STAMFORD CT 06902-3602 646-797-8471

1316975097 EVANCHICK CHRISTINE 2150 MAIN STREET SPRINGFIELD MA 01104-3300 860-741-6572

1487740650 EVANS BRIAN 60 WASHINGTON AVENUE SUITE 207 HAMDEN CT 06518-2601 203-288-5916

HUSKY Health Connecticut Page 18 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 19: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1376603365 EVANS JOEL 30 SHELBURNE RD STAMFORD CT 06902-9317 203-321-0200

1902895402 EVANS MICHAEL 200 ZACHARY ROAD MANCHESTER NH 03109-5607 603-621-3452

1831346337 EVANS TAYLOR LISA MEDICAL CENTER BLVD WINSTON SALEM NC 27157-0001 336-713-4944

1821225558 EVENCHIK BENJAMIN 725 NORTH STREET PITTSFIELD MA 01201-4019 413-447-2752

1356549018 FABBRI REMO 32 TRUMBULL STREET NEW HAVEN CT 06511-6310 203-787-4589

1144459314 FABRE MARIA 111 BREWSTER STREET PAWTUCKET RI 02860-4474 401-921-7566

1952644650 FABRIZIO VERONICA 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1467747071 FACTOR MATTHEW 20 YORK STREET NEW HAVEN CT 06510-3220 203-688-9503

1710952064 FAGUNDES LINDA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1366403107 FAIRCHILD LYNN 701 COTTAGE GROVE RD BLOOMFIELD CT 06002-3080 860-243-3020

1669599734 FAJE ALEXANDER ZERO EMERSON PLACE SUITE 112 BOSTON MA 02114-2114 617-726-0038

1417062357 FALES ROBERT 85 CHURCH ST MIDDLETOWN CT 06457-3647 860-344-8606

1063722353 FALK JOY 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0797

1659471761 FALKOFF ALAN 30 BUXTON FARM RD STAMFORD CT 06905-1224 203-322-7070

1689814048 FARAG GALLEON ANAS 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1649481615 FARBER GREGORY 1060 DAY HILL ROAD WINDSOR CT 06095-5719 860-688-5595

1215025986 FARBER JOSHUA 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2770 203-932-5711

1760408280 FARBER STEVEN 950 CAMPBELL AVE MAIL STOP 111I WEST HAVEN CT 06516-2770 203-937-3446

1831307024 FAUCHER SHIRLEY 161 WEST MAIN STREET DUDLEY MA 01571-3817 508-949-2944

1235235029 FAY MONIQUE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1497732887 FAZELI POUNEH ZERO EMERSON PLACE SUITE 112 BOSTON MA 02114-2217 617-726-7948

1497049126 FAZZINGA NANCY 25 VALLEY DRIVE GREENWICH CT 06831-5203 203-622-4301

1215130034 FEDEN JEFFREY 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1417998592 FEDERMAN DANIEL VA CT (11ACSL) 950 CAMPBELL AVE WEST HAVEN CT 06516-2700 203-932-5711

1144307414 FEINBERG DENNIS 2875 MAIN STREET STRATFORD CT 06614-4979 203-375-3411

1720050313 FEIT LLOYD 1 HOPPIN STREET CORO WEST PROVIDENCE RI 02903-4923 401-793-8830

1184647802 FELDMAN AILEEN 51 NORTH MAIN ST SUITE 1A SOUTHINGTON CT 06489-2515 860-628-9121

1043578131 FELDMAN BRYAN 1924 ALCOA HWY KNOXVILLE TN 37920-1511 800-645-3055

1023169000 FELICE PATRICK 580 COTTAGE GROVE RD SUITE 103 BLOOMFIELD CT 06002-3088 860-242-0505

1649458290 FELIS DAVIES MARY JO 140 SHERMAN STREET 2ND FLOOR FAIRFIELD CT 06824-5849 203-255-2403

1538221999 FELIU PAUL 736 IRVING AVENUE SYRACUSE NY 13210-1690 800-645-3055

1750746590 FELIX JENNY 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1265725493 FELLER ROSS 2 DUDLEY STREET SUITE 200 PROVIDENCE RI 02905-3248 401-626-3872

1356781710 FENG YUN 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1053382978 FENNELL GAIL 75 HOLLY HILL LANE GREENWICH CT 06830-6098 203-276-6151

1912055757 FERRARO ROBERT 319 MAYBROOK RD WATERBURY CT 06708-3235 203-755-3396

1629268156 FERRERI RUTH 20 YORK STREET, CB-2041 NEW HAVEN CT 06510-3220 203-688-1734

1801146980 FESHARAKI ZADEH ARMAN 800 HOWARD AVENUE YALE MEMORY CLINIC NEW HAVEN CT 06510-3220 203-785-2094

1134396187 FICKENSCHER BEN 736 N BATTLEFIELD BLVD CHESAPEAKE VA 23320-4941 800-633-2243

1174525125 FIELDING KRISTIN 50 MEMORIAL BOULEVARD NEWPORT RI 02840-3636 401-606-4510

1811910953 FIGGIE MARK 535 E. 70TH STREET NEW YORK NY 10021-4823 646-707-8471

1710222013 FIGUEIREDO CATARINA 117 WALLACE AVENUE MOUNT VERNON NY 10552-3222 800-645-3055

1972713535 FILBERT ELIZABETH 1389 WEST MAIN ST SUITE 208 WATERBURY CT 06708-3115 203-757-1287

1831159367 FILOR CAROLINE 159 WEST PUTNAM AVENUE GREENWICH CT 06830-5329 203-869-7080

1306958442 FINA TERRENCE 100 PARK STREET GLENS FALLS NY 12801-4413 801-256-1900

HUSKY Health Connecticut Page 19 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 20: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1740259050 FINE JORY 3000 CORAL HILLS DR CORAL SPRINGS FL 33065-4108 623-580-6309

1912931775 FINES ROBERT 1001 SAM PERRY BLVD FREDERICKSBURG VA 22401-4453 800-645-3055

1346231974 FINN KATHLEEN 50 STANIFORD ST S50-5 BOSTON MA 02114-2517 617-643-0604

1164501763 FINNEGAN SARAH 555 WILLARD AVENUE NEWINGTON CT 06111-2631 860-666-6951

1952554636 FINNEGAN SHAWN 67 SAND PIT ROAD SUITE 208 DANBURY CT 06810-4032 203-853-0003

1770671224 FISCHBEIN ELLEN 355 HIGHLAND AVE SUITE 101 CHESHIRE CT 06410-2551 203-272-1208

1710943444 FISCHER JANET 201 W MAIN ST NIANTIC CT 06357-3777 869-451-3001

1932100666 FISH THOMAS 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1336183201 FISHER BRIAN 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1306914528 FISHMAN THEODORE 670 PROSPECT AVE HARTFORD CT 06105-4240 860-233-2600

1427092329 FITZGERALD GEOFFREY 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1134553704 FITZGERALD LAURA 1 TOWNE PARK PLZ NORWICH CT 06360-2247 860-887-0010

1760444145 FITZPATRICK TIMOTHY 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1558324210 FITZPATRICK JR PAUL 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1306839485 FITZSIMMONS LAURA PAMELA ROBUSTELLO 75 SEMINARY HILL RD. CARMEL NY 10512-1921 845-225-3400

1659311942 FLAGG JANET 555 WILLARD AVE NEWINGTON CT 06111-2631 860-666-6951

1972983120 FLANARY MICHAEL 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1457321531 FLEMING JAMES 620 BYRON RD HOWELL MI 48843-1002 800-645-3055

1457758708 FLORES JUAN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1396038543 FLUECKIGER PETER 20 YORK STREET CARDIOLOGY NEW HAVEN CT 06510-3220 203-785-6484

1144699653 FLYNN AMANDA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1912063181 FLYNN CHERYL 2 WAKE ROBIN RD SUITE 202 LINCOLN RI 02865-4241 401-333-1656

1114031390 FLYNN JACQUELINE 223 MEADOW ST SUITE #3 NAUGATUCK CT 06770-9994 203-723-5715

1417217431 FLYNN MARYELLIN UCONN HEALTH CENTER PSYCHIATRY 263 FARMINGTON AVE MC2103 FARMINGTON CT 06030-2103 860-480-6501

1992767354 FLYNN RICHARD 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1962434514 FLYNN WILLIAM 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1508072331 FOFANA KERFALA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1780935643 FOGWELL LEIGH CHILDREN'S & WOMENS PHYSICIAN 755 NORTH BROADWAY SLEEPY HOLLOW NY 10591-1076 914-366-3400

1942282363 FOISIE CRAIG 97 ELM STREET OLD SAYBROOK CT 06475-4144 860-388-4439

1962503854 FOLLETT JULIE 1268 MAIN ST SUITE 101 NEWINGTON CT 06111-3038 860-665-0039

1730348442 FOMBO DANIEL 5520 PARK AVENUE SUITE 303 PAIN&SPINE SPECIALISTS OF CT TRUMBULL CT 06611 615-224-5443

1447238126 FOOTIT CHRISTOPHER 8 RIVER DR HADLEY MA 01035-0380 413-259-9118

1083648125 FOREST LEE 2184 MAIN STREET STRATFORD CT 06615-5937 203-378-9002

1285847467 FORMAN LAURA 455 TOLL GATE ROAD WARWICK RI 02886-1417 401-273-0641

1437353182 FORSHAW DAVID 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1841258092 FORSMO SHARON 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1023406972 FORTE MARISSA 19 BRADHURST AVE SUITE 1700S HAWTHORNE NY 10532-2401 914-347-0162

1972592822 FORTIER LAWRENCE 465 SILAS DEANE HIGHWAY WETHERSFIELD CT 06109-2134 860-529-2500

1326012345 FORTIER NATASHA 119 BELMONT STREET UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01605-2903 508-334-8515

1396730610 FORTIER RENA 30 SHELBURN RD STAMFORD CT 06902-9314 203-276-7058

1568443125 FOSTER STANLEY 1625 STRAITS TURNPIKE STE 108 MIDDLEBURY CT 06762-1836 203-577-6550

1003074832 FOX ASHLEY 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1053351809 FOX DAVID 55 LOCK STREET NEW HAVEN CT 06511-3603 203-432-0076

1831139237 FOX MARK 1 ELM ST STE 2A TUCKAHOE NY 10707-3918 914-961-2515

HUSKY Health Connecticut Page 20 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 21: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1003974056 FOX TERESITA 201 EAST SAMPLE ROAD POMPANO BEACH FL 33064-3502 800-633-2243

1750356648 FRANCIS GAETANE 159 WEST PUTNAM AVENUE GREENWICH CT 06830-5329 203-869-7080

1598914129 FRANCIS JASMINE 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1417174939 FRANK RICHARD 909 HARTFORD TPK UNIT D6 WATERFORD CT 06385-1919 860-440-0700

1942413711 FRATARCANGELI KENNETH 2559 DIXWELL AVENUE HAMDEN CT 06514-1809 203-248-0072

1134273451 FREEMAN ADAM 329 RIVERSIDE AVE WESTPORT CT 06880-4301 203-227-3709

1013975614 FRENKEL TATYANA CONNECTICUT VALLEY HOSPITAL 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1295763902 FREYLE JAIME 909 49TH STREET BROOKLYN NY 11219-2923 914-962-8290

1659412112 FRIEDLER ALAN 419 WHALLEY AVENUE SUITE 101 NEW HAVEN CT 06511-3019 203-787-0520

1407900152 FRIEDMAN DANIEL 223 EAST 34TH ST NEW YORK NY 10016-4852 646-558-0859

1023048899 FRIEDMAN JEFFREY 153 SOUTH MAIN STREET NEWTOWN CT 06470-5310 203-270-7592

1285662577 FRIEDMAN STEVEN 909 49TH STREET BROOKLYN NY 11219-2923 914-962-8290

1437147121 FRIEDMAN VIDOR 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1639167398 FRIEND VICKI 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1093753865 FRISCH MARK 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1841515772 FROEHLICH ROSEMARY 101 DUDLEY STREET PROVIDENCE RI 02905-4474 401-273-0641

1326569237 FRUHBAUER LEINA 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1588691893 FRY ANTON 84 HOSPITAL AVENUE DANBURY CT 06810-6047 203-792-0400

1841204997 FUCIGNA ROBERT 30 SHELBURNE RD STAMFORD CT 06904-9317 203-276-7058

1114194008 FUFA DURETTI 535 E. 70TH ST. NEW YORK NY 10021-4823 646-797-8471

1588976724 FULLER JOEL 759 CHESTNUT STREET SPRINGFIELD MA 01107-1619 413-794-3233

1952314320 FULTON PAUL 63 HARMONY HILL RD CHEPACHET RI 02814-1429 401-949-0690

1194934943 FUNE JIMMY 250 PLEASANT STREET CONCORD NH 03301-2598 603-227-7000

1285746362 FUSCO FAITH 732 WEST ST SOUTHINGTON CT 06489-9999 860-559-1978

1306938634 GADE NANCY 436 DANBURY ROAD WILTON CT 06897-2023 203-210-7575

1548397920 GAEV BENNETT 167 DWIGHT RD LONGMEADOW MA 01106-1769 413-567-5533

1861437477 GAGNE GERARD 263 FARMINGTON AVENUE FARMINGTON CT 06030-5386 860-763-8716

1790880169 GAINES SARAH 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1134394109 GAINES-CARDONE ELIZABETH 1290 SUMMER STREET SUITE 3600 STAMFORD CT 06905-5325 203-325-3576

1972545689 GALAN ELIZABETH 52 PECK ROAD SUITE E TORRINGTON CT 06790-6107 860-482-6513

1710058318 GALLALEE JOHN 55 HARRISON AVE BRANFORD CT 06405-3607 203-488-0440

1780622449 GALLO ANTHONY 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-3534

1023211653 GALLO CORNELIA 8 BARBARA PLACE WESTPORT CT 06880-1234 203-226-3134

1235431560 GALLO DENISE 2890 MAIN ST. SUITE C STRATFORD CT 06614-5711 203-386-1410

1801978622 GALLO JAMES 828 TOLL GATE RD WARWICK RI 02886-2721 401-615-3043

1902869902 GALLUZZO KATHLEEN 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1275517567 GALVIS OSCAR 106 BOW STREET ELKTON MD 21921-5544 800-645-3055

1003808767 GANAL EDMUND 131 KENT ROAD NEW MILFORD CT 06776-3485 203-702-6640

1790729671 GANDHI ANJULA ONE BROOKDALE PLAZA BROOKLYN NY 11212-3198 800-432-4334

1023365707 GANDHI TANUJA 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1306868138 GANLY IAN 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1619085388 GANNON BARBARA CHILDREN'S & WOMAN'S PHYSICIAN 10 WEATHERVANE DR. WASHINGTONVILLE NY 10992-2242 914-922-2241

1447556972 GARCIA ALEXANDER 7050 GALL BLVD ZEPHYRHILLS FL 33541-1347 800-645-3055

1356355515 GARCIA ALFREDO CHILDREN''S & WOMENS PHYSICIAN 667 STONELEIGH AVE STE.111 CARMEL NY 10512-2455 845-279-9652

1982692687 GARCIA ANGELA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

HUSKY Health Connecticut Page 21 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 22: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1043383151 GARCIA LUCAS CONNECTICUT VALLEY HOSPITAL 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5000

1730143124 GARCIA AGUILAR JULIO 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1659389229 GARCIA MENDOZA ARMANDO 3000 CORAL HILLS DR CORAL SPRINGS FL 33065-4108 623-580-6309

1013970102 GARCIA-QUINONES SARIBEL CHILDREN'S & WOMENS PHYSICIAN 222 WESTCHESTER AVE. STE.201 WHITE PLAINS NY 10604-2926 914-698-5544

1952304263 GARDEN MITCHELL 622 BANTAM RD BANTAM CT 06750-0757 860-361-6650

1952364960 GARDNER DEBRA TORCHIA 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1912153032 GARDNER JOANNE MHC- VA MEDICAL CENTER 555 WILLARD AVE NEWINGTON CT 06111-2600 860-594-6365

1740575646 GARLAND MICHAEL 20 YORK STREET YNHH - DEPT OF C&A PSYCHIATRY NEW HAVEN CT 06510-3220 203-688-9503

1174559165 GARRETT AUDREY 55 NYE ROAD SUITE 102 GLASTONBURY CT 06033-1281 860-657-3056

1043409667 GARRETT LEILA 1 PERRYRIDGE ROAD GREENWICH CT 06830-4607 203-869-8353

1770670358 GARRO ARIS 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1962665570 GATEWOOD ANNA 23 CEDAR STREET NEW BRITAIN CT 06052-1301 860-827-0071

1467635623 GATSKEVICH ELENA 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1194807594 GAUDIO MICHAEL 850 NORTH MAIN ST EXT WESTVIEW WALLINGFORD CT 06492-2400 203-265-3355

1356303671 GAUDIO STEVEN 929 BOSTON POST ROAD SUITE 5 OLD SAYBROOK CT 06475-2143 860-575-2532

1629238886 GEDELA SATISH 1656 CHAMPLIN AVE UTICA NY 13502-4830 800-633-2243

1538282249 GEETTER DAVID 100 DEERFIELD RD WINDSOR CT 06095-4252 860-270-0600

1659341675 GEFFIN JOEL 1201 WEST MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4885

1033279658 GELB DAVID 836 FARMINGTON AVE SUITE 131 WEST HARTFORD CT 06119-1585 860-236-8550

1841379534 GELINAS JOHN 57 NORTH STREET SUITE 419 DANBURY CT 06810-5629 203-778-2020

1174883110 GEMME SETH 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1487615217 GENGA BRUCE 60 HOSPITAL ROAD LEOMINSTER MA 01453-2205 508-793-6348

1598727836 GENNARELLI LOUIS SOUNDSHORE MEDICAL CENTER 16 GUION PL NEW ROCHELLE NY 10801-5502 914-365-3831

1245359009 GENOVA JEFF 38 B GROVE ST. RIDGEFIELD CT 06877-4665 203-438-0458

1104142595 GENTHON ALISSA 375 BOYLSTON STREET BROOKLINE MA 02445 857-307-0861

1669447058 GENTILE PETER 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1548344500 GEORGE GEETA 30 MILESTONE ROAD DANBURY CT 08611-5114 203-702-7400

1437126018 GEORGE SUZANNE 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1811208838 GEORGE TRACEY ANN 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7274

1770535122 GESSLER CYNTHIA 169 MARTIN AVE EPHRATA PA 17522-1724 800-645-3055

1740527647 GESSLER TESS 109 BELMONT STREET WORCESTER MA 01605-2905 508-334-8152

1982882239 GHALY TAMER 500 CHASE PKWY WATERBURY CT 06708-3346 203-755-6677

1619113446 GHANIZADEH HALEH 238 NEWTOWN TURNPIKE REDDING CT 06896-2415 203-664-1977

1134227663 GHODAKE SHASHI 547 MAIN STREET MIDDLETOWN CT 06457-2806 860-346-3081

1407961733 GIALLOURAKIS COSMAS 55 FRUIT ST BLK 4 BOSTON MA 02114-2696 617-726-2026

1962679316 GIAMBANCO DEBORAH 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1770744518 GIANNINI NANCY CHILDREN'S & WOMAN'S PHYSICI 2529 ROUTE 52-STE 3 HOPEWELL JUNCTION NY 12533-3246 914-922-2241

1467570143 GIBBONS RYAN 3401 N BROAD ST PHILADELPHIA PA 19140-5103 215-707-1429

1740218429 GIBBS DIANNA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1609186410 GIBSON ANDREA 55 LAKE AVENUE, NORTH WORCESTER MA 01655-0002 508-334-8692

1588658934 GIEBISCH ROBERT 1635 CENTRAL AVENUE BRIDGEPORT CT 06610-2717 203-551-7464

1831283175 GILL PETER 333 SCHOOL ST PAWTUCKET RI 02860-5334 401-273-0641

1356313597 GILLLEGO AZUCENA 205-07 HILLSIDE AVENUE HOLLIS NY 11423-2220 718-464-5780

1295753218 GILROY RONALD 1350 S HICKORY STREET MELBOURNE FL 32901-3278 623-582-2141

1699896142 GIORDANO ROCCO 36 GRAND STREET FIRST FLOOR HARTFORD CT 06106-4608 860-826-4763

HUSKY Health Connecticut Page 22 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 23: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1720180367 GIOVETTI MARY 36 BRIDGE WAY PASCOAG RI 02859-0312 401-567-0800

1730146135 GIRARD BRIAN 20 YORK STREET YNHH DEPT OF RADIOLOGY NEW HAVEN CT 06510-3220 203-688-4242

1710914825 GIRASOLE GERARD 888 WHITE PLAINS RD TRUMBULL CT 06611-4552 203-268-2882

1164450300 GITLIN JORDAN 1999 MARCUS AVE STE M18 NEW HYDE PARK NY 11042-1023 914-962-8290

1518073386 GITTZUS JENNIFER 246 PLEASANT STREET SUITE 104 CONCORD NH 03301-2548 603-230-1939

1568522159 GLADSTEIN ERIC 70 VINE STREET NEW BRITAIN CT 06052-1431 860-223-1162

1477611101 GLASSER STEVEN 73 NORTH WATER STREET GREENWICH CT 06830-5815 203-531-9354

1972941664 GLEESON TIMOTHY 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1922212984 GLIDDEN PATRICIA 300 LONGWOOD AVE BOSTON MA 02115-5724 617-355-8537

1477504637 GLIEBERMAN OSCAR 10 ELMGROVE AVE. PROVIDENCE RI 02906-4124 401-274-4445

1194024364 GME HAMADEH SALIM 36475 5 MILE ROAD LIVONIA MI 48154-1971 800-645-3055

1225058605 GO JENSEN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1730274093 GODIN DAVID 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1952378127 GODWIN LOYD 4 CORPORATE DRIVE SUITE 386 SHELTON CT 06484-6240 203-538-5682

1447426986 GOEL AMIT 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795-4927 800-633-2243

1104893171 GOETZ JORDAN 555 WILLARD AVE VA CONNECTICUT HEALTHCARE NEWINGTON CT 06111-2631 860-666-6951

1790965150 GOGCU SEMSA CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE STE 1400 HAWTHORNE NY 10532-2144 914-922-2241

1215094693 GOGGANS FREDERICK 6 GLEN COVE DRIVE ROCKPORT ME 04856-4240 800-645-3055

1881937472 GOINS KRISTINE 230 S. FRONTAGE RD. YNHH CPIS NEW HAVEN CT 06519-3220 203-785-3370

1013956010 GOLD JEFFREY 2440 WHITNEY AVE HAMDEN CT 06518-3222 203-281-5745

1053397810 GOLDBERG DAVID 455 TOLL GATE ROAD WARWICK RI 02886-2759 401-921-7566

1194948323 GOLDBERG JOSEPH 128 EAST AVENUE NORWALK CT 06851-5738 203-854-9607

1154413920 GOLDBERG RICHARD 46 WEST AVON RD. AVON CT 06001-3679 860-675-0262

1174621999 GOLDBERG SCOT 180 OLD HAWLEYVILLE RD, UNIT 4 BETHEL CT 06801-3044 203-744-2663

1104821560 GOLDMAN BORIS 32 IMPERIAL AVENUE WESTPORT CT 06880-4328 203-222-3700

1043208754 GOLDMAN DAVID 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1710087614 GOLDNER STEPHEN 40 COMMERCE PARK SUITE 1 MILFORD CT 06460-3506 203-878-3531

1356610638 GOLDSCHMIDT JEFFREY 6 PARK PLACE NEW BRITAIN CT 06052-1407 860-224-7751

1932591047 GOLDSMITH STEPHANIE 94 LOCUST AVENUE DANBURY CT 06810-5954 203-798-0500

1831158088 GOLDSTEIN JEFFREY 201 EAST 69TH STREET MEZZANINE 2C NEW YORK NY 10021-5471 516-488-4411

1891896700 GOLDSTEIN LAURENCE 85 SEYMOUR ST SUITE 1025 HARTFORD CT 06106-5530 860-527-8588

1285642595 GOLDSTEIN LEON 141 DURHAM ROAD, SUITE 23 MADISON CT 06443-2658 203-245-0350

1124123559 GOLISANO GARRETT 172 MT. PLEASANT RD. NEWTOWN CT 06470-1443 203-426-0045

1518352459 GOLSHIRAZIAN CORINNE 281 EAST HARTFORD AVENUE UXBRIDGE MA 01569-1278 508-334-6556

1437295979 GOMES ANA PAULA 1132 NEW BRITAIN AVE. WEST HARTFORD CT 06110-2413 860-236-6928

1104117514 GOMES DANILO 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1659671493 GOMEZ REBECCA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1699786178 GOMEZ VANESSA 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1194977603 GONG ZHAODI 1 LONG WHARF DRIVE SUITE 212 NEW HAVEN CT 06511-5593 203-676-1524

1801932306 GONZALES ARRIETA BEVERLY 55 LAKE AVENUE NORTH DEPARTMENT OF ANESTHESIOLOGY WORCESTER MA 01655-0002 508-334-3271

1891102026 GONZALEZ CAROL 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1093006884 GOODWIN KELLY 32 FRUIT ST YAW 7B BOSTON MA 02114-2696 617-724-4000

1619971066 GOOGEL FREDRIC 1268 MAIN STREET SUITE 206 NEWINGTON CT 06111-3038 860-666-5674

1598753006 GORDON EDWARD 388 HARDSCRABBLE RD NO SALEM NY 10560-1020 914-669-5526

HUSKY Health Connecticut Page 23 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 24: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1174868517 GORDON PAULETTE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1730125618 GORICH GEORGE 672 STONELEIGH AVE C-116 CARMEL NY 10512-4634 914-441-8504

1285714048 GORLITSKY MICHELE 171 RAMAPO RD STE 4 GARNERVILLE NY 10923-1595 845-947-1772

1447346838 GOTH MELANIE CHILDREN'S & WOMAN'S PHYSICIAN 10 RONALD REAGAN BLVD. WARWICK NY 10990-4104 914-922-2241

1689128548 GOTTIER ALEXANDRA 450 CLINTON STREET THUNDERMIST HEALTH CENTER WOONSOCKET RI 02895-3207 401-767-4100

1972671238 GOTTLIEB DAVID 10 MOTT AVE NORWALK CT 06850-3320 203-854-9104

1508838509 GOTTLIEB LARRY 4697 MAIN STREET BRIDGEPORT CT 06606-1801 203-374-1027

1679627798 GOUDIE BRETT 593 EDDY STREET PROVIDENCE RI 02903-4923 401-793-8830

1174751358 GOULD LAURA ONE GENERAL STREET LAWRENCE MA 01841-2961 978-683-4000

1609847565 GOULET MICHELLE 395 PLEASANT ST NORTHAMPTON MA 01060-3914 413-584-7787

1619965282 GOYAL ANAY 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1841291853 GRABOWY MARION 84 N. MAIN STREET BLDG 2 BRANFORD CT 06405-3061 203-626-0160

1831585520 GRACE JOANNE 601 E ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1285809673 GRAHAM NICOLE 425 GEORGE STREET NEW HAVEN CT 06511-5410 203-688-3182

1164538419 GRANIERO RICHARD 4 SHAWS COVE NEW LONDON CT 06320-1234 860-437-3611

1679693527 GRANT IRENE 167 BENEDICT AVENUE TARRYTOWN NY 10591-4202 914-524-0715

1952484149 GRANTHAM CHRISTOPHER 4422 3RD AVENUE BRONX NY 10457-2545 800-645-3055

1073777165 GRASSO ELIZABETH 6 GREENWICH OFFICE PARK GREENWICH CT 06831-5100 203-869-1145

1346218989 GRAVES PETER 455 TOLLGATE ROAD WARWICK RI 02866-2759 401-273-0641

1881648434 GRAZIANO JENNY 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1790915569 GRAZIANO THOMAS 2150 MAIN STREET SPRINGFIELD MA 01104-3300 860-741-6572

1265503189 GREEN DANIEL 535 EAST 70TH STREET NEW YORK NY 10021-4823 646-797-8471

1750480141 GREEN ERROL 800 WASHINGTON STREET BOSTON MA 02111-1552 617-636-4720

1831386218 GREENBERG DONNA 200 ORCHARD STREET SUITE 207 NEW HAVEN CT 06511-5363 203-776-4444

1780773119 GREENBERG WILLIAM CHILDREN'S & WOMAN'S PHYSICIAN 4C MEDICAL PARK DRIVE POMONA NY 10970-3516 914-922-2241

1881925907 GREENWOOD ANA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1710908611 GREVE MARK 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1821431735 GRIEPP MATTHEW 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016

1558743286 GRIMALDO ALICIA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1841589173 GRINSHTEYN SIMON 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1811250194 GRISWOLD MATTHEW 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1962450908 GROSSER MAYER 1656 CHAMPLIN AVE UTICA NY 13502-4830 800-633-2243

1477543080 GROTTKAU BRIAN 55 FRUIT ST YAW 3E BOSTON MA 02114-2696 617-726-8523

1962726620 GRUNSCHEL BETH VA CT HEALTHCARE SYSTEM 950 CAMPBELL AVENUE (151D) WEST HAVEN CT 06516-2770 203-932-5711

1174531172 GUARDINO PAUL 501 FARMINGTON AVENUE FARMINGTON CT 06032-1901 860-674-4334

1538103791 GUDENKAUF TAMI 250 MERCY DR DUBUQUE IA 52001-7320 800-645-3055

1699885863 GUERINA NICHOLAS 455 TOLL GATE ROAD WARWICK RI 02886-2759 401-273-0641

1346471521 GUERTIN JENNIFER 119 BELMONT STREET WORCESTER MA 01605-2903 508-334-8152

1730595828 GUERTIN MAGGIE 48 SANDERSON STREET GREENFIELD MA 01301-2613 413-773-2626

1639103955 GUGLIELMO THOMAS 131 KENT ROAD NEW MILFORD CT 06776-3485 860-354-8616

1316340797 GUGLIOTTI CHRISTINA 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1881661817 GUIDA MANON 622 HEBRON AVE SUITE 107 GLASTONBURY CT 06033-5007 860-657-3376

1417340662 GULYAS MONIKA 94 LOCUST AVENUE DANBURY CT 06810-5954 203-798-0500

1467662601 GUNDAJI SURESH 29 LEWIS AVE GREAT BARRINGTON MA 01230-1713 413-447-2752

1952370595 GUNSHER SHARON 246 PLEASANT STREET SUITE 205 CONCORD NH 03301-2548 603-224-0584

HUSKY Health Connecticut Page 24 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 25: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1902184005 GUPTA AARTI 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-026-2500

1154523264 GUSTIN JEFFREY 320 KINGS HIGHWAY EAST FAIRFIELD FAMILY DENTAL GROUP FAIRFIELD CT 06825-4813 203-337-6262

1508860552 GUTIERREZ MATTHEW 246 PLEASANT STREET SUITE 103 CONCORD NH 03301 603-224-6070

1215257548 GUYUMDZHYAN KARAPET 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1053303768 HACK JASON 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1730278185 HACKELL JESSE CHILDREN'S & WOMAN'S PHYSICI 4C MEDICAL PARK DRIVE POMONA NY 10970-3516 914-922-2241

1679897318 HADFIELD NEIL 101 PAGE STREET NEW BEDFORD MA 02740-3464 508-973-3584

1770890246 HAENSCH NANCY 181 WHITE STREET LITCHFIELD HALL DANBURY CT 06810-6826 203-837-8590

1104012293 HAGEN JEAN 915 RIVER RD MIDDLETOWN CT 06457-4405 860-704-4198

1356669162 HAHN JR EDWARD 195 EASTERN BOULVARD SUITE 200 GLASTONBURY CT 06033-1208 860-781-6294

1679665525 HAIMS MARK 1017 FARMINGTON AVENUE WEST HARTFORD CT 06107-2106 860-521-6767

1477793917 HAKIMI ABRAHAM 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1881635639 HAMBLETT KATIE 455 TOLLGATE ROAD WARWICK RI 02886-2759 401-273-0641

1750570172 HAMDI MOHAMAD 101 DUDLEY STREET PROVIDENCE RI 02905-1447 401-273-0641

1124318068 HAMEEDI FAWAD 30 SHELBURN RD STAMFORD CT 06902-9314 203-276-7058

1386084887 HAMEL CHERYL 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1730475203 HAMEL MAUREEN 101 DUDLEY STREET PROVIDENCE RI 02905-2241 401-273-0641

1508870007 HAMEROFF HARVEY 10 DALE STREET WEST HARTFORD CT 06107-1815 860-521-9451

1841429206 HAMILTON HEATHER 4 CORPORATE DR. SUITE 386 SHELTON CT 06484-6240 203-538-5682

1427090455 HAMILTON PAUL 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1891747846 HAMILTON ROBERT 7800 US HWY 98 WEST DESTIN FL 32550-7228 317-583-3460

1568835007 HAMLETT RACHEL 3300 MAIN ST 3RD FL, SUITE C & D SPRINGFIELD MA 01199-1619 413-794-5600

1003839234 HAMPTON BRITTANY 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1932243870 HAMPTON WILLIAM 38 LAKE AVE. GREENWICH CT 06830-4515 203-869-3950

1346252913 HAN HELEN 1320 MAIN STREET WILLIMANTIC CT 06226-1940 860-450-7583

1336124676 HAN YUNCHENG 850 STRAITS TURNPIKE, STE 203 MIDDLEBURY CT 06762-2843 203-758-2300

1407885841 HANDELSMAN DAN CHILDREN'S & WOMAN'S PHYSICIAN 755 N BROADWAY STE. 500 SLEEPY HOLLOW NY 10591-1077 914-922-2241

1750602983 HANNA GLENN 450 BROOKLINE AVENUE LW-204 DANA FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1902840119 HANNANIAN FARSHAD 475 NORTHERN BLVD. GREAT NECK NY 11021-4812 516-773-3048

1588664692 HANNES ANDREW CHILDREN'S & WOMAN'S PHYSICIAN 91 LAKES RD MONROE NY 10950-2694 914-922-2241

1407848278 HARAM-MOURABET SOHEIR CHILDREN'S & WOMAN'S PHYSICI 16 GUION PL NEW ROCHELLE NY 10801-5502 914-922-2241

1285728782 HARAN MARY 51 NORTH MAIN ST SUITE 1A SOUTHINGTON CT 06489-3515 860-628-9121

1760853873 HARDEN TAYLOR VICKI 5520 PARK AVENUE STE. 303 TRUMBULL CT 06611-3466 631-445-0593

1215925573 HARDING NICOLE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1528490018 HARKIN KATHERINE 55 LAKE AVENUE NORTH UMASS MEMORIAL WORCESTER MA 01655-0002 774-443-7552

1508184821 HARKNESS SARAH 101 PAGE STREET NEW BEDFORD MA 02740-3464 508-973-3584

1720126386 HARRINGTON PHILIP 175 GRAND AVENUE NEW HAVEN CT 06513-3939 203-865-1668

1538577168 HARRIS JACQUELINE 759 CHESTNUT STREET 2ND FLOOR SPRINGFIELD MA 01199-1619 413-794-3233

1831175520 HARRIS MICHELLE ONE GENERAL STREET LAWRENCE MA 01841-2961 978-683-4000

1952583767 HARRIS NATASHA 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1215065503 HARRIS STEPHEN 454 WOLCOTT STREET WATERBURY CT 06705-1239 203-755-0399

1902185184 HART ASHLEY 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1912334590 HARTE AMANDA 435 LEWIS AVE MERIDEN CT 06451-2101 203-694-8200

1841359080 HARVEY MARGARET 31 RIVER RD COS COB CT 06807-2152 203-863-2003

1720154354 HASAPIS PETER 173 EAST AVE NEW CANAAN CT 06840-5614 203-972-4218

HUSKY Health Connecticut Page 25 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 26: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1780632968 HASBANI MAYER 136 SHERMAN AVENUE SUITE 505 NEW HAVEN CT 06511-5238 203-562-8071

1225022973 HASBANI MOSHE 136 SHERMAN AVENUE SUITE 505 NEW HAVEN CT 06511-5235 203-562-8071

1336119411 HASKELL SALLY 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2770 203-932-5711

1699886358 HASSETT MICHAEL 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1255405387 HATIBOGLU FERDA 295 WASHINGTON AVE HAMDEN CT 06518-3025 203-248-2500

1679739288 HAUGHEY JOHN 7050 GALL BLVD ZEPHYRHILLS FL 33541-1347 800-645-3055

1649231879 HAUSER MARK 16 CONVERSE AVENUE NEWTON MA 02458-2504 617-969-6331

1215070917 HAVEN LYNNE 49 LAKE AVENUE GREENWICH CT 06830-4501 203-869-4242

1184912867 HAWBAKER NICOLAUS 1200 N BEAVER STREET FLAGSTAFF AZ 86001-3118 800-645-3055

1659458123 HAXBY ROBERT 164 HIGH STREET GREENFIELD MA 01301-2613 413-773-2263

1982716049 HAY SEONAID 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2770 866-808-7921

1063487718 HAYDEN DONNA MARIE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1669516589 HAYDEN KAREN 164 SUMMIT AVENUE PROVIDENCE RI 02906-2853 401-793-4102

1447267612 HAYDEN RONALD 725 NORTH STREET PITTSFIELD MA 01201-4109 413-447-2752

1154879674 HAYES ALLISON 84 HOSPITAL AVENUE DANBURY CT 06810-6047 203-792-0400

1558524223 HAYES GINA 736 IRVING AVENUE SYRACUSE NY 13210-1690 800-645-3055

1629049465 HAYES KATHLEEN 300 SUMMIT STREET HEALTH CTR HARTFORD CT 06106-3100 860-297-2017

1518308477 HAYWARD ANTHONY 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-6484

1407992605 HAYWOOD KARL 42 WRIGHT STREET PALMER MA 01069-1138 413-284-5400

1356420418 HAZNEDAR MUSTAFA 39 WEST 14TH STREET SUIT 506 NEW YORK NY 10011-7403 917-225-4968

1376534784 HEALD PETER 73 SAND PIT RD SUITE 207 DANBURY CT 06810-4015 203-792-4151

1376719187 HEANEY JESSICA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1275602575 HEDLESKY STEVEN 301 TYSON AVE PARIS TN 38242-4544 800-432-4334

1285896480 HEEBNER CARDWELL DORCAS 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1295714657 HEGARTY CATHERINE 2150 MAIN STREET SPRINGFIELD MA 01104-3300 860-741-6572

1912332396 HEGG JAMES 925 FARMINGTON AVENUE KENSINGTON CT 06037-2295 860-828-0868

1427499821 HEIL KARSTEN 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016

1740376706 HEINEMANN MURK 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1679541213 HEINL ROBERT 455 TOLL GATE RD WARWICK RI 02886-2759 401-737-7000

1003867714 HELFAND IRA 1515 ALLEN STREET SPRINGFIELD MA 01118-1803 413-783-9114

1124215983 HENDERSON MARC 255 NORTH MAIN STREET BRISTOL CT 06010-4972 860-589-7170

1780786517 HENDIZADEH PEDRAM 1881 POST RD FAIRFIELD CT 06824-5721 203-255-1036

1013072453 HENNESSY BRIAN 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1548211543 HENNING ALLISON 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1164549978 HENSHAW JOLENE 3700 SOUTH MAIN ST BLACKSBURG VA 24060-7017 804-267-4364

1346473782 HENSLEY GARY 14502 W MEEKER BLVD SUN CITY WEST AZ 85375-5282 801-256-1900

1457451551 HERBERT JOSHUA 5 HIGH RIDGE PARK SUITE 103 STAMFORD CT 06905-1328 203-276-4644

1437198702 HERBST ANDREW 148 EAST AVE SUITE 3B NORWALK CT 06851-1481 203-957-3535

1851320345 HERNANDEZ DENNIS 601 E ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1467511568 HERNANDEZ-AVILA CARLOS 1000 SILVER STREET CONNECTICUT VALLEY HOSPITAL MIDDLETOWN CT 06457-7023 860-262-5868

1780654780 HERSH STANLEY 1201 WEST MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4885

1336215698 HESSE FREDERICK ARMS ACRES REHAB, INC. 75 SEMINARY HILL RD. CARMEL NY 10512-1912 845-225-3400

1811130313 HESSICK CHRIS 600 NORTHERN BLVD ALBANY NY 12204-1004 800-645-3055

1316977119 HESSION MELISSA 701 ENFIELD STREET ENFIELD CT 06082-2961 860-741-6572

1366676066 HEYWOOD-GREGORY KAMILAH CHILDREN''S & WOMENS PHYSICIAN 19 BRADHURST AVE. STE. 1400 HAWTHORNE NY 10532-2144 914-922-2241

HUSKY Health Connecticut Page 26 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 27: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1245374685 HIERHOLZER MEENA 201 EAST SAMPLE RD POMPANO BEACH FL 33064-3502 954-847-4572

1861944084 HIGGINBOTHAM THOMAS 1 HOSPITAL PLAZA STAMFORD HOSPITAL STAMFORD CT 06902-3602 646-797-8471

1023147428 HIGGINS DONALD 74 EAST MAIN STREET PLAINVILLE CT 06062-4903 860-793-9613

1609890698 HILL JESSE 701 COTTAGE GROVE RD. E110 BLOOMFIELD CT 06002-3080 860-882-6168

1033493945 HILL MELANIE 146 WEST RIVER STREET 3RD FLOOR, SUITE 11-D PROVIDENCE RI 02904-2609 401-793-5700

1578723334 HILLS OSCAR 495 ORANGE STREET NEW HAVEN CT 06511-3809 203-772-7912

1548510985 HINDS MICAYLA 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-6000

1588782064 HINES AMANDA CHILDREN'S & WOMENS PHYSICIAN 255 LAFAYETTE AVE., SUFFERN NY 10901-4812 914-493-8558

1245690106 HINMAN SCOTT 131 KENT ROAD NEW MILFORD CT 06776-3485 203-702-6640

1083809420 HIRSCH DAVID 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1407908379 HIRSCH JODY CHILDREN''S & WOMEN''S PHYSICI 50 PLAZA WEST,MUNGER PAVILION, VALHALLA NY 10595-1533 914-594-3415

1801279427 HIRSCHEGGER KARL 725 NORTH STREET PITTSFIELD MA 01201-4124 413-447-2752

1124248463 HITZEMAN LAWRENCE 275 7TH AVE 3RD FL NEW YORK NY 10001-6708 646-574-7832

1285893453 HOBBS GABRIELA 100 BLOSSOM ST BOSTON MA 02114-2606 617-724-1124

1235459678 HODES VILLAMAR LINDA 933 BRADBURY DRIVE SE SUITE 2222 ALBUQUERQUE NM 87106-4375 505-272-3295

1003136235 HODSON BENJAMIN 2215 BURDETT AVE TROY NY 12180-2466 518-271-3450

1538261003 HOFFMAN LYNNE 480 MAMARONECK AVENUE HARRISON NY 10528-1621 914-341-1088

1053447227 HOGAN ANN 26 STRAWBERRY HILL AVENUE SUITE 2F STAMFORD CT 06902-2631 203-348-9338

1992746135 HOGAN ERIN 455 TOLL GATE RD WARWICK RI 02886-2759 401-273-0641

1164837449 HOGAN KAREN 3300 MAIN STREET SPRINGFIELD MA 01199-1619 413-794-7394

1558345512 HOJMAN HORACIO 1246 CHALKSTONE AVE PROVIDENCE RI 02908-3904 401-331-1350

1184007445 HOLAK RITA 40 COMMERCE PARK SUITE 1 MILFORD CT 06460-3535 203-878-3531

1336370246 HOLLAND CRISTINA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1841533577 HOLLAND DAVID 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1811964257 HOLLECK JURGEN WATERBURY PRIMARY CARE,VA-CT 95 SCOVILST 2ND FLOOR, CROFT WATERBURY CT 06706-1126 203-465-5292

1770581415 HOLMBOE JEFFREY 1253 N. CANAL BLVD REDMOND OR 97756-1334 800-645-3005

1811976871 HOLOVACS THOMAS 55 FRUIT ST YAW 3G BOSTON MA 02114-2696 617-726-0298

1609878362 HOM CHRISTINE CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 1400 HAWTHORNE NY 10532-2140 914-922-2241

1255674750 HONG PETER 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1104918697 HONIG DAVID 111 EAST AVENUE 111 EAST AVENUE NORWALK CT 06851-5014 203-853-6777

1295836187 HOO GEORGE 642 STILLWATER ROAD STAMFORD CT 06902-1727 203-323-5799

1629043997 HOOD TARA 201 W MAIN ST NIANTIC CT 06357-1014 860-451-3068

1033550801 HOOPER KATHARINE 11 SOUTH ROAD SUITE 250 FARMINGTON CT 06032-2484 203-770-5665

1225102387 HOPE SUSAN 61 SOUTH MAIN STREET #209 WEST HARTFORD CT 06107-2486 860-313-1352

1962646067 HORBAL TERRENCE 555 BRIDGEPORT AVE 2ND FLR SHELTON CT 06484-4749 203-913-9193

1558469437 HOROWITZ JEFFREY CHILDREN'S & WOMAN'S PHYSICI 10 RONALD REAGAN BLVD. WARWICK NY 10990-4104 914-922-2241

1952407843 HORTON PAUL 321 RESEARCH PARKWAY SUITE 106 MERIDEN CT 06450-8341 203-235-2505

1508883588 HOSKINS DONNA 62 CARTER ROAD KENT CT 06757-0607 860-927-3772

1851542708 HOTCHKISS KAREN 1 TURKEY HILL ROAD SOUTH WESTPORT CT 06880-5525 203-240-3323

1972593887 HOUSER RICHARD 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1952468969 HOWARD KATHERINE 500 ENTERPRISE DRIVE ROCKY HILL CT 06067-3913 615-224-5005

1417935818 HOWARD LISA 701 ENFIELD STREET ENFIELD CT 06082-2961 860-741-6572

1114298270 HOWE KERIN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1689651614 HOWE ROBERT 281 MAPLE STREET EAST LONGMEADOW MA 01028-2712 413-525-5160

1285747287 HOWELL ROGER 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

HUSKY Health Connecticut Page 27 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 28: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1508084377 HOY ERIK 455 TOLL GATE ROAD JOHNSON BUILDING WARWICK RI 02886-2791 401-273-0641

1811108210 HOYT JENNIFER 13710 ST. FRANCIS BOULEVARD MIDLOTHIAN VA 23114-3267 804-627-5536

1811987142 HUANG MARY 55 FRUIT ST BOSTON MA 02114-2696 617-726-2737

1306243597 HUANG PHYU 300 W. HUNTINGTON DR. ARCADIA CA 91007-3402 800-645-3055

1033471206 HUBBARD KRISTEN 1351 S COUNTY TRL STE 115 EAST GREENWICH RI 02818-0281 401-421-4000

1447291448 HUESGEN CHRISTOPHER 101 HOSPITAL CENTER BLVD STAFFORD VA 22554-6200 800-645-3055

1811959547 HUGHES JEFFREY 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1417055302 HUGHES JOHN 950 CAMPBELL AVE WEST HAVEN CT 06516-2221 203-932-5711

1730516147 HULL KATRINA 48 SANDERSON STREET GREENFIELD MA 01301-2778 413-773-2022

1699922278 HUNG YU TING 500 W. PUTNAM AVE. GREENWICH CT 06830-6086 203-622-0303

1245368513 HUNGERFORD MARYSUSAN 2420 MAIN STREET SUITE 3 STRATFORD CT 06615-1234 203-556-5223

1467671917 HUNT JANICE 69 SHERMAN STREET FAIRFIELD CT 06824-5821 203-255-0468

1235169798 HUNT MICHAEL 762 LINDLEY STREET ST.VINCENTS FAMILY HEALTH CTR BRIDGEPORT CT 06606-5046 203-576-5131

1184781205 HUNTMASON DIANNE 67 NORTH MAIN STREET ESSEX CT 06426-1357 860-860-7677

1437495975 HUSKIC HASNIJA 1579 STRAITS TURNPIKE LOWER LEVEL MIDDLEBURY CT 06762-1836 203-598-7246

1487903431 HUSKINS CHELSEA 5151 PARK AVENUE FAIRFIELD CT 06825-8224 203-365-4720

1407056559 HWANG ANITA 915 HARTFORD TPK WATERFORD CT 06385-4229 860-443-3250

1235235318 HWANG HAEYOUNG CHILDREN'S & WOMAN'S PHYSICIAN 130 GRAND ST. CROTON ON HUDSON NY 10520-2307 914-922-2241

1215941893 HWANG MICHAEL 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1174757629 HYSON ANNE 950 CAMPBELL AVE 11-ACSL-1 WEST HAVEN CT 06516-2770 203-932-5711

1609892207 IGLESIAS JULIE 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1598944910 IGOE MICHELLE 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0791

1144563677 ILER JEFFREY 20 YORK STREET YNHH FITKIN 6 NEW HAVEN CT 06510-3220 203-785-2618

1306153580 IMMORDINO PETER 263 FARMINGTON AVENUE FARMINGTON CT 06030-0900 860-679-5500

1578554952 INGLIS ALLAN 535 E. 70TH STREET NEW YORK NY 10021-4823 646-797-8471

1720083298 INNAIMO DONN 380 MAIN STREET #5 WATERTOWN CT 06795-2260 860-274-8858

1194769976 INNES LORRAINE 333 ADAMS ST BEDFORD HILLS NY 10507-2001 914-241-0758

1245454115 ISRAELY ROBERT 26 IMPERIAL AVE WESTPORT CT 06880-4308 203-221-1001

1629394267 IVAN YARON 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1790843837 IWASAKI JOHN 19 PADANARAM RD DANBURY CT 06811-4824 203-748-8055

1245247311 JACKMAN ALEXIS 3020 WESTCHESTER AVENUE SUITE 303 PURCHASE NY 10577-2525 914-253-8070

1306940994 JACKSON TERENCE 47 OAK ST. #240 STAMFORD CT 06905-5345 203-252-2252

1649397068 JACOBS ALLAN 61 SOUTH MAIN STREET SUITE 305 WEST HARTFORD CT 06107-2403 860-561-1640

1326133604 JACOBS GREGG 85 PRESCOTT STREET WORCESTER MA 01605-2610 508-334-6556

1275690034 JACOBS SELBY 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7016

1043271513 JACOBS SUZANNE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1295852440 JACOBS-STANNARD ANDREA 20 YORK STREET, CB-2041 NEW HAVEN CT 06510-3220 203-688-1734

1336196716 JACOBSON JONATHAN DEVEREUX FOUNDATION 60 MILES RD RUTLAND MA 01543-0219 508-886-4746

1174875421 JACOBSON MELISSA 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1164519120 JACOBSON RONALD CHILDREN'S & WOMENS PHYSICIAN 755 N BROADWAY STE 540 SLEEPY HOLLOW NY 10591-1077 914-358-0190

1598807869 JACOBSON STUART 484 BOSTON POST ROAD DARIEN CT 06820-9999 203-656-3900

1578539151 JADERQUIST-BASSETT CATHLEEN 142A DANIELSON PIKE FOSTER RI 02825-1475 401-567-0800

1245324771 JAHN MARGARET CHILDREN''S & WOMAN''S PHYSICI 755 N BROADWAY STE. 500 SLEEPY HOLLOW NY 10591-1077 914-922-2241

1427137785 JAMAL HABIB 14 RYE RIDGE PLAZA SUITE247 RYE BROOK NY 10573-2858 914-253-4985

1497822605 JAMBOR CLINTON 34 DALE ROAD SUITE 208 AVON CT 06001-3659 860-677-0079

HUSKY Health Connecticut Page 28 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 29: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1972753945 JAMES CECELIA 7 OLD SHERMAN TURNPIKE SUITE 102 DANBURY CT 06810-7174 203-947-5529

1881723054 JAMIESON N GARY 79 PARK PLACE WINSTED CT 06098-1705 860-379-5898

1811037708 JANIKAS JOHN 2215 BURDETT AVE TROY NY 12180-2466 518-271-3450

1942298591 JANWADKAR SHAKUNTA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1982725537 JARMON JOSEPH 88 RYDERS LANE LIGHTHOUSE DENTAL CARE STRATFORD CT 06614-1666 203-378-1566

1598781791 JASINSKI JOHN 761 MAIN AVE SUITE 102 NORWALK CT 06851-0001 860-282-4133

1760538102 JAZIRI WALID NORWICH PSYCHIATRIC CENTER 108 NEW LONDON TPKE. NORWICH CT 06360-2645 860-889-3052

1467487074 JENKINS SALLY 250 PLEASANT STREET CONCORD NH 03301-2598 603-227-7000

1871668707 JENNETTE ROBERT 185 BIRCH ST WILLIMANTIC CT 06226-2141 860-465-5263

1952429011 JENNINGS DANNA 60 TEMPLE STREET SUITE 8B NEW HAVEN CT 06510-2716 203-401-4349

1578775243 JIANG JIN 60 WASHINGTON AVE SUITE 202 HAMDEN CT 06518-9999 203-281-6574

1598082919 JILLANI ASIF 1579 STRAITS TURNPIKE LOWER LEVEL MIDDLEBURY CT 06762-1836 203-598-7246

1285998740 JILLANI SARAH 20 YORK STREET YNHH- PSYCHIATRY NEW HAVEN CT 06510-3202 203-688-9503

1003011339 JIMENEZ LINCOLN 5151 N. 9TH AVENUE PENSACOLA FL 32504-8721 850-416-6961

1225170640 JOHN BRIAN 1 HOSPITAL PLAZA STAMFORD HOSPITAL STAMFORD CT 06902-3602 646-797-8471

1649637521 JOHNS MORGAN 415 RIVERSIDE DRIVE NORTH GROSVENORDALE CT 06255-2165 860-923-1181

1730181355 JOHNSON ALISON 100 HAYNES STREET 2ND FLOOR MANCHESTER CT 06040-4113 860-533-3091

1942424007 JOHNSON ANN 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1639239072 JOHNSON AVON 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7274

1477715951 JOHNSON DAVA 79 PAYNE ROAD BETHEL CT 06801-1111 203-743-1150

1316957285 JOHNSON DIANE GRANOFF HALL SCSU 10 WINTERGREEN AVE NEW HAVEN CT 06515-1330 203-392-6300

1831432665 JOHNSON KIM 20 YORK STREET YNHH - TOMPKINS 20, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1811147598 JOHNSON LARRY 25A GREEN HOLLOW ROAD DANIELSON CT 06239-3509 860-779-0374

1871694976 JOHNSON RHEA 66 MAIN STREET REAR OFFICE BEDFORD HILLS NY 10507-1814 914-341-2060

1750355384 JOHNSON RICHARD 50 STANIFORD ST S50-200 BOSTON MA 02114-2914 617-726-2914

1285846766 JOHNSON STEPHANIE 7800 US HWY 98 WEST DESTIN FL 32550-7228 850-416-6961

1306909601 JOHNSTON LISABETH 361 PARK ROAD WEST HARTFORD CT 06119 860-523-1101

1306811690 JOLLEY LINDSEY 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1427061779 JONAS BRIDGETTE 60 HOSPITAL ROAD LEOMINSTER MA 01453-2205 508-793-6348

1093947608 JONES CATHERINE 363 HIGHLAND AVE FALL RIVER MA 02720-3703 508-973-3584

1932352051 JONES GAIL 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1609931831 JONES JANICE 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1346209640 JORDAN RACHEL 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1922194901 JORDEN ROBERT 6 GLEN COVE DRIVE ROCKPORT ME 04856-4240 800-645-3055

1619035243 JOSE JENNIFER 688 POST ROAD DARIEN CT 06820-4717 203-662-9602

1760559934 JOSEL MARK 4 NORTHWESTERN DRIVE BLOOMFIELD CT 06002-3444 860-243-3344

1528230463 JOSEPH JOBY 1761 WEST BROAD STREET FRANK A ROSS AND ASSOCIATES STRATFORD CT 06615-5752 203-375-3763

1114090818 JOVINO LOUISE CHILDREN'S & WOMAN'S PHYSICIAN 446 ROUTE 304-STE E BARDONIA NY 10954-1617 914-922-2241

1982049896 JOYCE RYAN 263 FARMINGTON AVE FARMINGTON CT 06030-6325 860-679-3312

1457322158 JUAN PAUL 25 VALLEY DRIVE GREENWICH CT 06831-5203 203-622-4301

1215910922 JURZYK RONALD 464 WOLCOTT ROAD WOLCOTT CT 06716-2626 203-879-6171

1154322550 JUSTER FERN CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 2400 HAWTHORNE NY 10532-2144 914-922-2241

1710080387 KABAKOFF SETH 928 FARMINGTON AVENUE WEST HARTFORD CT 06107-1929 860-233-2322

1598714701 KACKIELO HANNA 1 TOWNE PARK PLAZA NORWICH CT 06360-2259 317-509-3900

HUSKY Health Connecticut Page 29 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 30: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1104073220 KACZANOWSKI KRISTEN 647 CLINTON AVE 2ND FLOOR BRIDGEPORT CT 06605-1711 203-335-7260

1588003339 KADLEC MARY BETH 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1619138799 KADRI ASLAM 74 SHERWOOD LANE NORWICH CT 06360-5248 860-639-7213

1558482323 KADZIELSKI SARAH 55 FRUIT ST YAWKEY 6C BOSTON MA 02114-2696 617-726-8705

1609890565 KAEDING JOHN 528 WASHINGTON HIGHWAY MORRISVILLE VT 05661-8973 508-482-9600

1699965871 KAFFMAN ARIE 555 WILLARD AVE VA-MHC NEWINGTON CT 06111-2600 860-666-6951

1558354142 KAGDIS CAROL 6900 MAIN STREET STRATFORD CT 06614-4946 203-386-6488

1427043538 KAGE BARBARA 361 MAIN STREET MANCHESTER CT 06040-4127 860-646-9929

1588747182 KAHN STEVEN 391 BROAD STREET MERIDEN CT 06450-5844 203-237-0002

1548318926 KALACZNIK MONICA 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1225164320 KALE MILIND 1225 SILVER STREET MIDDLETOWN CT 06457-3920 860-638-2629

1225115645 KALMAN ARLENE 54 ARROWHEAD ROAD BROOKFIELD CT 06804-1532 203-775-6100

1497730675 KALMAN DAVID 2150 MAIN STREET SPRINGFIELD MA 01104-3300 860-741-6572

1861745259 KALOWSKY BENOIT MARGUERITE 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-224-5438

1376626978 KAMANITZ JOYCE 670 PROSPECT AVE HARTFORD CT 06105-4240 860-233-2600

1043234792 KAMAT ACHYUT 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1093702334 KAMIREDDY NAGIREDDY 1320 MAIN ST WILLIMANTIC CT 06226-1940 860-450-7583

1982764593 KANABAR HASMUKH 304 WRIGHT STREET SWEETWATER TN 37874-1181 800-645-3055

1861896524 KANAGAKI ALYSSA 3300 MAIN STREET 3RD FLOOR, STE A SPRINGFIELD MA 01199-1619 413-794-7031

1023291705 KANAMA MALEK 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1528181716 KANDRO SHARON 327 HIGH ST. DAVISON HEALTH CENTER MIDDLETOWN CT 06459-3232 860-685-2470

1477644698 KANGANIS POLLY CHILDREN'S & WOMAN'S PHYSICI 4 STUDIO ARCADE BRONXVILLE NY 10708-2631 914-922-2241

1952395568 KAPLAN JEFFREY 4699 MAIN STREET SUITE 106 BRIDGEPORT CT 06606-1830 203-374-8182

1568455137 KAPLAN JERROLD 2200 WHITNEY AVE. SUITE 200 HAMDEN CT 06518-3602 203-407-7727

1174683437 KAPLAN MARVIN 1111 PARK AVENUE NEW YORK NY 10128-1234 212-348-7575

1154359834 KAPLAN RANA 1275 YORK AVE NEW YORK NY 10065-6007 623-582-2141

1053379099 KAPOOR REENA 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1013983691 KARACSONYI EVA 2150 MAIN STREET SPRINGFIELD MA 01104-3300 860-741-6572

1558390948 KARDOS KATRINA 600 NORTHERN BLVD ALBANY NY 12204-1004 800-645-3055

1396876371 KARLIN JAN 7600 DR PHILLIPS BLVD STE 58 ORLANDO FL 32819-7231 407-226-0609

1700894177 KARLIN ROGER 88 STATE ROUTE 37 NEW FAIRFIELD CT 06812-5036 203-746-2436

1386816544 KARLOSKY LORAN 620 SKYLINE DR JACKSON TN 38301-3923 623-582-2141

1861459182 KARNASIEWICZ MICHAEL 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1578738787 KARPENOS ILANA CENTER FOR DISCOVERY 1320 MILL HILL RD SOUTHPORT CT 06890-1234 203-955-1381

1386726750 KARTHAS NANCY 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1871593590 KASE JORDAN CHILDREN''S & WOMAN''S PHYSICI 100 WOODS RD VALHALLA NY 10595-1530 914-922-2241

1891803581 KASETA SUZANNE CHILDREN'S & WOMAN'S PHYSICIAN 10 WEATHERVANE DR. WASHINGTONVILLE NY 10992-2242 914-922-2241

1710085741 KASHAF SUSAN 950 CAMPBELL AVE 11ACSL-B WEST HAVEN CT 06516-2700 866-808-7921

1689782401 KASSARIS CHRIS 1881 POST RD FAIRFIELD CT 06824-5721 203-255-1036

1245210798 KASULINOUS GERALDINE 2 S BRIDGE DR AGAWAM MA 01001-2015 413-789-7455

1801936539 KATES MATTHEW 26 BURLING LN 2ND FL NEW ROCHELLE NY 10801-5625 914-235-1888

1023117512 KATIS JAMES 145 OLD MILL ROAD GREENWICH CT 06831-3015 203-622-1213

1326147257 KATTNER MARIA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1174762165 KATZ ADAM 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 508-334-0042

HUSKY Health Connecticut Page 30 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 31: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1033137252 KATZ BENJAMINE 100 PARK STREET GLENS FALLS NY 12801-4413 518-926-1000

1780651745 KATZ JEFFREY 595 MAIN STREET MANCHESTER CT 06040-5160 860-646-1000

1912240474 KATZ RACHEL 300 GEORGE STREET YNHH - PSYCH NEW HAVEN CT 06511-6662 203-688-9503

1679502140 KATZ STEVEN 664 PROSPECT AVENUE HARTFORD CT 06105-4203 860-231-2850

1134216732 KATZ THEODORE 157 GOOSE LANE GUILFORD CT 06437-2100 203-453-4475

1184616963 KATZENSTEIN MARTIN CHILDREN'S & WOMAN'S PHYSICIAN 255 LAFAYETTE AVE SUFFERN NY 10901-4812 914-922-2241

1598787855 KATZOFF NORMAN 87 SLATER AVENUE JEWETT CITY CT 06351-2408 860-376-2624

1922380070 KAUR JASLEEN 1000 SILVER STREET BOX 351 MIDDLETOWN CT 06457-7023 860-262-5000

1134567092 KAUR RAVDEEP 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1427387646 KAY LINDA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1538201942 KAYE ALAN 1106 NORTH AVE BRIDGEPORT CT 06604-2710 475-225-8070

1730591850 KAYE ALFRED 300 GEORGE STREET YALE PSYCHIATRY SUITE 901 NEW HAVEN CT 06511-0666 203-785-2095

1821447053 KEAN JANINA 1031 FARMINGTON AVE. FARMINGTON CT 06032-1576 860-677-2550

1558390856 KEATING PAUL 196 DANBURY ROAD WILTON CT 06897-4150 203-762-5048

1487876272 KEEFE CHARLES 191 ALBANY TPKE CANTON CT 06019-2554 860-693-0887

1518186808 KEGEL LISA 56 FRANKLIN STREET WATERBURY CT 06706-1221 203-709-6000

1154748150 KEHOE ELIZABETH 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1619031267 KEILMAN CLINTON 2600 BRUCE B DOWNS BLVD WESLEY CHAPEL FL 33544-9207 800-645-3055

1508295262 KEISE COLLETE 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0797

1073650685 KEKU JOHN 100 AIRPORT RD. KINSTON NC 28501-1604 800-645-3055

1265808034 KELE MATTHEW 3300 MAIN STREET 3RD FLOOR, SUITE C&D SPRINGFIELD MA 01199-1619 413-794-7033

1740278589 KELLEHER DANIEL 72 NORTH STREET, STE 300 DANBURY CT 06810-5653 203-616-5234

1346608221 KELLER-SABEL NECHAMA 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1679809859 KELLEY PATRICIA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1417140815 KELLY GEORGE CONNECTICUT VALLEY HOSPITAL 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1649447228 KELLY KATHRYN 19801 OBSERVATION DR GERMANTOWN MD 20876-4070 800-645-3055

1962669259 KELLY PAMELA 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-4956

1124392352 KELLY SARENA 3203 MAIN STREET BRIDGEPORT CT 06606-4225 203-371-0009

1699015776 KELMENDI BENJAMIN 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1801867841 KEMENY NANCY 1275 YORK AVE MEMORIAL SOLID TUMOR GROUP NEW YORK NY 10065-6007 646-227-3742

1508142365 KENDRICK JESSIE 55 FRUIT ST BOSTON MA 02114-2696 617-724-4100

1811420136 KENNEDY ASHLEY 759 CHESTNUT STREET S3677 SPRINGFIELD MA 01107-1619 413-794-5161

1811000714 KENNEDY DANIEL 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1679548267 KENSINGER DANIEL 575 SIOUX POINT ROAD DAKOTA DUNES SD 57049-5312 605-217-4817

1578717815 KENTA-BIBI EUCHARIA CONNECTICUT VALLEY HOSPITAL 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5000

1205059417 KERNER BARRY 52 BEACH ROAD FAIRFIELD CT 06824-6017 203-254-2000

1679500086 KESSLER FRANK 3423 DANBURY ROAD BREWSTER NY 10509-4513 845-279-7200

1720405194 KESSLER MATTHEW 3423 DANBURY RD BREWSTER NY 10509-4513 845-279-7200

1083613244 KESZLER MARTIN 101 DUDLEY ST. PROVIDENCE RI 02905-2499 401-273-0641

1225221005 KEYES BRIAN 1400 WHITNEY AVENUE HAMDEN CT 06517-2459 203-248-2116

1538180427 KHAGHAN NEDA 500 WEST PUTNAM AVE SUITE 100 GREENWICH CT 06830-6086 203-863-2908

1780937466 KHALID KHALID 20 YORK STREET YNHH NEUROLOGY NEW HAVEN CT 06510-3220 203-688-4242

1265624944 KHAN AHMAD 7015 ALMEDA RD HOUSTON TX 77054-1111 832-224-5968

1184967085 KHANGURA RAMINDER 263 FARMINGTON AVE FARMINGTON CT 06030-2947 860-679-4763

1548526007 KHEANG SOPAGNA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

HUSKY Health Connecticut Page 31 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 32: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1215254784 KIBERENGE ROY 20 YORK STREET YNHH DEPT OF ANESTHESIOLOGY NEW HAVEN CT 06510-3220 203-688-9503

1801857255 KICA GERALDINA 455 TOLLGATE ROAD WARWICK RI 02886-2759 401-273-0641

1336481217 KIEL ROBERT VERNON PROFESSIONAL BUILDING 281 HARTFORD TURNPIKE, STE 202 VERNON CT 06066-4759 860-871-1311

1912211384 KIM CHRISTY CHILDREN''S & WOMAN''S PHYSICI 19 BRADHURST AVE. STE 1400 HAWTHORNE NY 10532-2144 914-922-2241

1376710665 KIM HAN JO 535 E. 70TH ST NEW YORK NY 10021-4823 646-797-8471

1477742062 KIM JAE 889 BRIDGEPORT AVENUE MILFORD CT 06460-3139 203-783-9899

1881822419 KIMBALL JACQUELYN 64 ROBBINS ST WATERBURY CT 06708-2613 203-573-6056

1396947420 KING JOHN 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1114472123 KING SUSAN 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-882-8673

1184608788 KING TARI 450 BROOKLINE AVENUE DANA FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1790944114 KINGHAM T 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1699794404 KINGSLEY STEPHEN 57 NORTH STREET SUITE 422 DANBURY CT 06810-5629 203-790-0777

1093943201 KINLER RAE LYNNE 2590 WHITNEY AVE UNIT 2 HAMDEN CT 06518-3044 225-806-1184

1437386174 KIRBY SARA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1699937722 KIRSCHNER JONATHAN 535 E. 70TH ST NEW YORK NY 10021-4823 646-797-8471

1538336789 KIRTZ JEREMY 7171 NORTH DALE MABRY HWY TAMPA FL 33614-2665 800-645-3055

1235549353 KITAY BRANDON 300 GEORGE STREET YALE PSYCHIATRY NEW HAVEN CT 06511-6662 203-785-2095

1861726291 KIWANUKA ANNE 135 SILVER STREET PAGE HALL 2ND FLOOR MIDDLETOWN CT 06457-1133 860-262-5055

1003961046 KLAGSBRUN SARAH 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1407141724 KLAUS CHRISTOPHER 1 RIVER STREET THUNDERMIST HEALTH CENTER WAKEFIELD RI 02879-3214 401-767-4100

1184924565 KLEIN ANDRE 75 SEMINARY HILL RD. CARMEL NY 10512-1921 845-225-3400

1215969142 KLEIN JAMES 1700 SOUTH TAMIAMI TRAIL SARASOTA FL 34239-3509 800-645-3055

1043658305 KLEIN MATTHEW 20 YORK ST. YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1033386867 KLEIN RHONDA 761 MAIN AVE SUITE 102 NORWALK CT 06851-1080 203-810-4150

1174579718 KLEMENT GIANNOULA 800 WASHINGTON STREET BOSTON MA 02111-1552 617-636-1465

1922268697 KLISIEWICZ SEBASTIAN 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1770539728 KLITZKE MARGARET 1011 VETERANS MEMORIAL PARKWAY EAST PROVIDENCE RI 02915-5061 401-432-1168

1336137058 KLOTH DAVID 100 MILL PLAIN ROAD DANBURY CT 06811-5178 203-792-5913

1225023203 KLUGMAN JEFFREY 400 PROSPECT STREET NEW HAVEN CT 06511-2181 203-404-6444

1205273539 KLUNK CHRISTOPHER 20 YORK STREET YNHH NEONATAL/PERINATAL MED. NEW HAVEN CT 06510-3220 203-688-4242

1609854983 KNAPP REBECCA SUSAN WAYNE CENTER 75 CHURCH ST. THOMPSON CT 06277-2609 860-928-5900

1376579110 KNIGHT LYDIA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1487852570 KNIGHT MICHAEL 1945 STATE ROUTE 33 NEPTUNE NJ 07753-4859 800-645-3055

1780627968 KO JANET 5501 OLD YORK ROAD PHILADELPHIA PA 19141-3018 623-582-2141

1568486215 KOBAYASHI LEO 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1033214358 KOBIALKA WALTER 1275 SUMMER ST STAMFORD CT 06905-5315 203-325-0764

1417243635 KOCH GREGORY 5353 REYNOLDS STREET SAVANNAH GA 31405-6015 800-432-4334

1326035031 KOCHERLAKOTA PRABHAKAR CHILDREN'S & WOMAN'S PHYSICIAN 70 DUBOIS ST. NEWBURGH NY 12550-4851 914-922-2241

1326361957 KODISH BRIAN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1073642393 KOEGLER ALBERT 652 BOSTON POST ROAD SUITE 7 GUILFORD CT 06437-2748 203-453-0015

1710128400 KOELSCH EMILY CHILDREN'S & WOMAN'S PHYSICIAN 150 WHITE PLAINS RD STE 101 TARRYTOWN NY 10591-5521 914-922-2241

1972849404 KOENIG DAVID 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1659777019 KOERS AMY 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-224-5005

1699785170 KOESTLER JENNIFER CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 2400 HAWTHORNE NY 10532-2144 914-922-2241

1639360340 KOHLER KRISTINA 34 SYCAMORE AVENUE SUITE 2A LITTLE SILVER NJ 07739-1228 732-747-9310

HUSKY Health Connecticut Page 32 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 33: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1306855218 KOKERNAK JAMES 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1275608879 KOLADE CHRISTINA 3851 MAIN STREET BRIDGEPORT CT 06606-2864 203-372-3333

1376618611 KOLADE EBENEZER 3851 MAIN STREET BRIDGEPORT CT 06606-2864 203-372-3333

1649292798 KOLENIK STEVEN 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1235169715 KOLEVZON ALEXANDER MOUNT SINAI MEDICAL CENTER 1 GUSTAVE L LEVY PL # 1230 NEW YORK NY 10029-6504 212-241-0961

1427098516 KOLMAN KARYN 2800 E. AJO WAY TUCSON AZ 85713-6204 801-256-1900

1922141381 KOMETZ-ROCK SMADAR 1 BRADLEY ROAD, SUITE 906 WOODBRIDGE CT 06525-2296 203-389-7747

1053332957 KONDEV VANJA 3241 MAIN STREET STRATFORD CT 06614-5236 203-283-9374

1013943083 KONG BOBBY 5301 E. HURON RIVER DR. ANN ARBOR MI 48106-0995 800-645-3055

1710253786 KOONKITTI PARICHART 2600 BRUCE B DOWNS BLVD WESLEY CHAPEL FL 33544-9207 800-645-3055

1659709202 KOONTZ CHRISTOPHER 195 EASTERN BOULEVARD SUITE 200 GLASTONBURY CT 06033-1208 860-781-6294

1760601116 KOPAR PIROSKA 20 YORK STREET YNHH DEPT SURGERY TRAUMA NEW HAVEN CT 06510-3220 203-688-4242

1710045703 KOPARAN TULIN 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1760407043 KOPE WALTER 162 MOUNTAIN ROAD SUFFIELD CT 06078-2091 860-668-1211

1396709556 KOPF RICHARD 132 MAIN ST DANBURY CT 06810-7863 203-794-1979

1952586018 KORBLY NICOLE 101 PLAIN STREET 5TH FLOOR PROVIDENCE RI 02903-4825 401-273-0641

1770656878 KORVAL ARNOLD 8 WEST END AVENUE OLD GREENWICH CT 06870-1642 203-637-3212

1346417722 KOSOFSKY SONG MIN 308 CALLAHAN RD NORTH KINGSTOWN RI 02852-9999 401-567-0800

1912031295 KOSTER MICHAEL 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-7396

1669442687 KOSTINA-O'NEIL YANINA 1201 WEST MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4885

1982785341 KOTLYAR VIKTOR 1000 SILVER STREET BOX 351 MIDDLETOWN CT 06457-7023 860-262-5868

1558479501 KOVAL MATTHEW 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-8853

1164654190 KOWALSKI KIRSTEN 94 LOCUST AVENUE DANBURY CT 06810-5954 203-798-0500

1770640336 KOZLOWSKI MARK 620 ROUTE 32 UNCASVILLE CT 06382-0566 860-848-1291

1295045680 KOZUB BRADLEY 91 WATER STREET MILFORD MA 01757-3005 508-334-8152

1679863799 KRAHM DAVID J 1700 SOUTH TAMIAMI TRAIL SARASOTA FL 34239-3509 800-645-3055

1811005622 KRAVETZ JEFFREY 950 CAMPBELL AVENUE 11ACSL WEST HAVEN CT 06516-2770 203-932-5711

1891735742 KREEGEL PAIGE 3269 STOCKTON HILL RD KINGMAN AZ 86409-3619 800-633-2243

1902001431 KREMSDORF ROBIN 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-6484

1467481341 KRESSLEY ELISABETH 2 WILDWOOD MEDICAL CENTER ESSEX CT 06426-1428 860-767-2186

1528108412 KRISA JOHN 2215 BURDETT AVENUE TROY NY 12180-2466 800-645-3055

1457312100 KRISS TERRENCE 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1245206663 KRITZER LESTER 935 MAIN STREET LEVEL B MANCHESTER CT 06040-6059 860-649-0233

1992786842 KROGIUS TOR 30 LOCUST ST NORTHAMPTON MA 01061-5001 800-432-4334

1578551081 KRUGER MARK 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1972602209 KRUGER SUSAN WEST HAVEN VA 950 CAMPBELL AVE WEST HAVEN CT 06516-2770 203-932-5711

1306820592 KRUGLICK BRUCE 1700 SOUTH TAMIAMI TRAIL SARASOTA FL 34239-3509 800-645-3055

1801984927 KRULEE DAVID 1062 BARNES ROAD #207 WALLINGFORD CT 06492-6013 203-265-4600

1134102395 KUE RICKY 85 EAST CONCORD STREET 3RD FLOOR BOSTON MA 02118-2393 617-414-6033

1003952169 KUHL JOSEPHINE 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1366443434 KUHNLEY EDWARD 189 STORRS ROAD MANSFIELD CENTER CT 06250-1683 860-465-5906

1710973987 KULKARNI RAGHAVENDRA 725 NORTH STREET PITTSFIELD MA 01201-4019 413-447-2752

1407823081 KULKE MATTHEW 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1548336472 KULOWSKI THOMAS 225 NORTH MAIN STREET SUITE 210 BRISTOL CT 06010-4984 860-582-3744

1144295007 KULSHRESHTHA MANISHA 4422 3RD AVE BRONX NY 10457-2545 800-645-3055

HUSKY Health Connecticut Page 33 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 34: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1083814040 KUMAR ANEEL 877 JEFFERSON AVENUE MEMPHIS TN 38103-2897 800-645-3055

1285920454 KUMAR NEIL 263 FARMINGTON AVENUE FARMINGTON CT 06030-4037 860-679-6600

1902880255 KUMAR SMITA CHILDREN'S & WOMAN'S PHYSICIAN 4350 VAN CORTLANDT PARK EAST BRONX NY 10470-1875 914-922-2241

1669566022 KUNDEL LEONARD 1867 SUMMER STREET STAMFORD CT 06905-5016 203-487-6020

1316920218 KUNKEL JOEL MED NOW, P.C. 1040 BARNUM AVENUE STRATFORD CT 06614-4968 203-377-5733

1386641637 KUPIEC MICHAEL 736 IRVING AVENUE SYRACUSE NY 13210-1690 800-645-3055

1174604532 KURIAN LESLIE 1635 CENTRAL AVENUE BRIDGEPORT CT 06610-1254 203-551-7464

1912965708 KURIEN SANTHA 27 HOSPITAL AVE SUITE 304 DANBURY CT 06810-5954 203-743-3833

1962645192 KURLANDER CARA 950 CAMPBELL AVENUE FIRM A, MAIL CODE 11ACSL WEST HAVEN CT 06516-2770 203-932-5711

1285655365 KURTH PAMELA 345 NORTH MAIN ST SUITE 302 WEST HARTFORD CT 06117-2515 860-233-9772

1790710069 KURTZ BRYAN 1101 NOTT ST SCHENECTADY NY 12308-2425 801-256-1900

1518114859 KWAN DANIEL 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-5495

1033178926 L HEUREUX CYNTHIA 201 WEST MAIN STREET NIANTIC, CT 06357-1410 860-451-3001

1558730630 LA ROSA DANIELA 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-882-8673

1649604331 LACHANT LINDSAY 94 LOCUST AVENUE DANBURY CT 06810-5954 203-798-0500

1003937301 LAFAYETTE JEAN 1 NORTHWESTERN DR BLOOMFIELD CT 06002-0342 860-242-0700

1902079304 LAFF RACHEL 950 CAMPBELL AVE WEST HAVEN CT 06516-2770 203-932-5711

1205110533 LAGRASTA CHRISTINE 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1275518102 LAIRD DENNIS 64 ROBBINS STREET WATERBURY CT 06708-2613 215-442-5046

1346211380 LAKE DIANA 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1104147446 LAKIN ASHLEY 111 BREWSTER STREET PAWTUCKET RI 02860-4474 401-273-0641

1326276445 LAMA MAXIMO 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1023125598 LAMANA SAMUEL 43 WOODLAND STREET, STE G-80 GOTHIC PARK HARTFORD CT 06105-2363 860-533-3091

1144668229 LAMARRE REYNALD 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-0355

1336183235 LAMBERT BRYCE 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1013179456 LAND LARRY 2600 BRUCE B DOWNS BLVD WESLEY CHAPEL FL 33544-9207 800-645-3055

1407034945 LANDMANN DAN 1351 WASHINGTON BLVD STAMFORD CT 06902-2468 203-327-5808

1659646875 LANDRENEAU MARK 20 YORK STREET YNHH NEUROLOGY NEW HAVEN CT 06510-3220 203-688-4242

1538198940 LANDRES RACHEL CHILDREN''S & WOMENS PHYSICIAN 100 WOODS ROAD VALHALLA NY 10595-1530 914-922-2241

1346324027 LANDRETH BARBARA 115 E 67TH ST APT 1C NEW YORK NY 10065-5990 212-772-7569

1356761829 LANE CHADRICK 300 GEORGE STREET YALE PSYCHIATRY NEW HAVEN CT 06511-6663 203-785-2095

1144245747 LANE JOSEPH 535 EAST 70TH ST NEW YORK NY 10021-4823 631-329-6925

1265699862 LANE SARA 525 E 68TH STREET NEW YORK NY 10065-4870 623-582-2141

1528038841 LANGE DALE 535 E. 70TH STREET NEW YORK NY 10021-4823 646-797-8471

1619916707 LANGERMAN SUSAN 950 CAMPBELL AVE WEST HAVEN CT 06516-2770 203-932-5711

1386027373 LANGLEY MARYELLEN 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-8853

1902022908 LANKER MARK 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1407842966 LANTNER TARRASH RITA 3000 CORAL HILLS DR CORAL SPRINGS FL 33065-4100 954-847-4572

1265420798 LAPP JOHN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1386907731 LAROCHELLE NICHOLAS 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1013271998 LAROCHELLE ZEA 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1003188814 LASKY JODI 171 GRANDVIEW AVE SUITE 101 WATERBURY CT 06708-2519 203-757-9336

1932322120 LASSER JAY CENTER FOR WORK STRESS REDUCTI 1031 FARMINGTON AVENUE FARMINGTON CT 06032-1576 860-679-0473

1629003918 LAST GARY 580 COTTAGE GROVE ROAD BLOOMFIELD CT 06002-3032 860-242-8644

HUSKY Health Connecticut Page 34 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 35: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1598707762 LASTOMIRSKY DAVID 111 BEACH ROAD 3RD FLOOR FAIRFIELD CT 06824-6668 203-255-2340

1043470735 LATIF SYED 20 YORK STREET YNHH DEPT OF CARDIOLOGY NEW HAVEN CT 06510-3220 203-688-4242

1134180912 LATIMER JOHN WACHUSETT EMERGENCY PHYSICIANS 60 HOSPITAL RD LEOMINSTER MA 01453-2205 978-466-2995

1922129337 LATOWICKI DANIEL 992 DANBURY ROAD WILTON CT 06897-4808 203-544-9301

1780670240 LAU KIRKLAND 111 SALEM TURNPIKE SUITE 7 NORWICH CT 06360-6459 860-859-2262

1821229386 LAUFER ILYA 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1457674947 LAVELY RICHARD 20 LITTLE FOX LN MONROE CT 06468-1607 203-795-4117

1477867455 LAVINE KELLEY 326 WASHINGTON STREET WILLIAM W BACKUS HOSPITAL NORWICH CT 06360-2740 860-889-8331

1386087252 LAWTON KELLEY 36 EAST MAIN STREET AVON CT 06001-3801 860-674-0333

1912076613 LAZAR JOAN 55 NYE ROAD SUITE 102 GLASTONBURY CT 06033-1281 860-657-3056

1285186148 LEAHY HELEN 439 MILL HILL AVENUE BRIDGEPORT CT 06610-2866 203-334-2100

1306929302 LEALI ALEJANDRO 535 E. 70TH ST. NEW YORK NY 10021-4823 646-797-8471

1093170524 LEBLANC JEANNE 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7274

1144203001 LEBOEUF WILLIAM 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7089

1922170679 LEDERMAN LAURENCE 12 CURTIS STREET MERIDEN CT 06450-5900 203-237-5232

1083978233 LEDESMA MICHELE 20 YORK STREET YNHH DEPARTMENT OF PEDICATRICS NEW HAVEN CT 06510-3220 203-688-9503

1841432903 LEE CHUNG HAN 300 WESTCHESTER RD MSK HARRISON WEST HARRISON NY 10604-6007 646-227-3742

1255354973 LEE DOUGLAS 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1235265919 LEE EUDOCIA DANA FARBER CANCER INSTITUTE 450 BROOKLINE AVENUE BOSTON MA 02215-5450 617-632-2166

1912970864 LEE LISA 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0797

1629189980 LEE MOON 2397 BLACK ROCK TPKE FAIRFIELD CT 06825-3229 203-372-8961

1457676645 LEE THERESA 20 YORK STREET, CB-2041 NEW HAVEN CT 06510-3220 203-688-1734

1972582989 LEFRAK KAREN 106 BOW STREET ELKTON MD 21921-5544 800-645-3055

1093731333 LEGARE ROBERT 11 WELLS ST WESTERLY RI 02891-2959 401-273-0641

1780692335 LEIBOWITZ LAWRENCE 36 GROVE STREET 1ST FLOOR NEW CANAAN CT 06840-5329 203-966-6305

1972823961 LEINBAUGH ERRYN 725 NORTH STREET PITTSFIELD MA 01201-4019 413-447-2752

1558302513 LEINHARDT KATHRYN 55 LOCK STREET NEW HAVEN CT 06511-8237 203-432-0076

1801186101 LEKWAUWA RUBY 300 GEORGE ST STE 901 NEW HAVEN CT 06511-6662 203-785-2095

1750479549 LENT KIRA 60 LAFAYETTE ST BRIDGEPORT CT 06604-1358 203-576-4712

1225099245 LEONARD DIANNE 100 NORTH ACADEMY AVE. DANVILLE PA 17822-2018 570-214-9907

1144255316 LEONHARDT MERRILEE 68 BRIDGE STREET SUITE 206 SUFFIELD CT 06078-3107 860-254-5360

1861515454 LERCH NANCY SUMMER 2 CHURCH STREET SOUTH SUITE 311 NEW HAVEN CT 06519-1717 203-624-5256

1578522454 LERCHE ADAM CHILDREN'S & WOMAN'S PHYSICIAN 446 ROUTE 304-STE E BARDONIA NY 10954-1617 914-922-2241

1154391159 LESSER ROBERT 1201 WEST MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4885

1881785673 LESTER MITCHELL 148 EAST AVENUE SUITE 3G NORWALK CT 06851-5727 203-838-4034

1881785673 LESTER MITCHELL 148 EAST AVENUE SUITE 3G NORWALK CT 06851-5727 203-838-4034

1134405970 LEUCHTEN SCOTT 4422 3RD AVE BRONX NY 10457-2545 800-645-3055

1215931829 LEVADA ANDREW 1201 MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4885

1821098245 LEVEN LEONARD 3 WEST END AVENUE OLD GREENWICH CT 06870-1640 914-347-4510

1629019807 LEVENSON LAWRENCE 240 BRADLEY STREET NEW HAVEN CT 06510-1108 203-562-3048

1174851117 LEVESQUE CAITLIN 420A SCRABBLETOWN RD NORTH KINGSTOWN RI 02852-3638 401-295-7400

1518955236 LEVI DAVID 67 SAND PIT RD STE 308 DANBURY CT 06810-4032 203-743-7246

1679508469 LEVIN GALE 52 BEACH ROAD SUITE 104 CYRIL WAYNIK MD PC FAIRFIELD CT 06824-6017 203-254-2000

HUSKY Health Connecticut Page 35 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 36: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1730291766 LEVIN STEVEN 1 LONG WHARF DR STE 212 NEW HAVEN CT 06511-5593 203-624-4208

1821038902 LEVINE ALANNA CHILDREN'S & WOMAN'S PHYSICI 422 WESTERN HWY TAPPAN NY 10983-1311 914-922-2241

1992824296 LEVINE ROBERT 120 MINEOLA BOULEVARD SUITE 210 MINEOLA NY 11501-4077 516-663-4938

1154473817 LEVINE RONALD 475 COGNEWAUGH RD COS COB CT 06807-9999 203-629-5560

1306040860 LEVINE SARA GREENWICH ADOLESCENT MEDICINE 239 GLENVILLE ROAD GREENWICH CT 06831-4172 203-532-1919

1225004765 LEVINE STEVEN 160 HAWLEY LANE TRUMBULL CT 06611-5379 203-380-3707

1790992196 LEVINE WENDY 1275 POST RD STE 202 FAIRFIELD CT 06824-6024 203-259-0880

1366551319 LEVINSON PERITZ 16 JADA LANE GREENWICH CT 06830-4051 203-869-0079

1679551410 LEVISOHN STEVEN 50 STANIFORD ST 3RD FLOOR BOSTON MA 02114-2517 617-726-3558

1427361112 LEVY JILLIAN 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-443-7552

1972887511 LEWIS ELLEN 260 RIVERSIDE AVE 2ND FLOOR WESTPORT CT 06880-4804 203-916-4000

1912109265 LEYTIN VICTORIA 455 TOLLGATE ROAD WARWICK RI 02886-2759 401-273-0641

1013337823 LI LUMING 300 GEORGE STREET YALE PSYCHIATRY NEW HAVEN CT 06511-6664 203-785-2095

1598861247 LIEBERT PETER CHILDREN'S & WOMAN'S PHYSICIAN 222 WESTCHESTER AVE STE.202 WHITE PLAINS NY 10604-2926 914-922-2241

1023039146 LIEBMANN OTTO 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1609835362 LIEBOWITZ NEIL 1031 FARMINGTON AVENUE FARMINGTON CT 06032-1411 860-677-2550

1669584686 LIGHAM DWIGHT 1 LONG WHARF DR STE 212 NEW HAVEN CT 06511-5593 203-624-4208

1659465003 LIGORSKI MARK 72 NORTH ST. SUITE 201 DANBURY CT 06810-5653 203-798-0068

1194757633 LIN JEN JAR MEDICAL CENTER BLVD WINSTON SALEM NC 27157-0001 623-580-6309

1528000858 LINCOLN LESILEY 55 FRUIT ST YAW 4B BOSTON MA 02114-2696 617-724-6700

1982757555 LINDBLAD ROY 325 MAIN STREET FARMINGTON CT 06032-2977 860-677-7753

1841283736 LINDEN ROBERT 20 YORK ST NEW HAVEN CT 06510-3202 203-688-2984

1992874812 LINKE GARY 60 WASHINGTON AVE HAMDEN CT 06518-3271 203-288-9944

1043230600 LINN NOREEN 222 WESTCHESTER AVENUE SUITE 205 WHITE PLAINS NY 10604-2926 914-949-9882

1508897786 LINSEISEN JERRY 528 WASHINGTON HIGHWAY MORRISVILLE VT 05661-8973 802-888-8313

1407873334 LIPMAN STEPHEN 230 BROAD STREET WINDSOR CT 06095-2925 860-688-4634

1528243367 LIPPMAN MELANIE 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1114089687 LIPSCHITZ DEBORAH 21 SHERMAN COURT FAIRFIELD CT 06824-5825 203-256-9926

1487650693 LITCHMAN CHARISSE 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1447341243 LITCHMAN MARK 148 EAST AVENUE SUITE 3G NORWALK CT 06851-5727 203-838-4034

1407881600 LIVINGSTON RUSSELL 41 PACELLA PARK DRIVE RANDOLPH MA 02368-1755 781-437-1386

1578709044 LIVINGSTONE TAMARA 759 CHESTNUT STREET S3677 SPRINGFIELD MA 01199-1619 413-794-5365

1831143700 LLEWELLYN ANTHONY 450 SOUTH OCOTILLO ST BENSON AZ 85602-6403 800-432-4334

1639250087 LLOVET ROXANA 1635 CENTRAL AVENUE BRIDGEPORT CT 06610-2717 203-551-7464

1043272156 LOCHRIDGE JILLIEN 300 LONGWOOD AVE BOSTON MA 02115-5724 617-919-7307

1003855339 LOCKHART GREGORY 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1548282569 LOCKHART JEFFREY 246 PLEASANT STREET SUITE 103 CONCORD NH 03301-2548 603-224-6070

1700931342 LOGAN KIMBERLY BERKSHIRE MEADOWS 249 NORTH PLAIN RD. HOUSATONIC MA 01236-9741 413-528-2523

1811089873 LOIEWSKI DAVID 115 SPENCER ST WINSTED CT 06098-1140 860-738-6985

1346467164 LOMBARDI KRISTIN 1 HOPPIN STREET CORO WEST PROVIDENCE RI 02903-4923 401-793-8830

1063404374 LOMBARDI MARIA CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 2400 HAWTHORNE NY 10532-2144 914-922-2241

1225102247 LONDON DAVID 567 VAUXHALL STREET EXTENSION SUITE 218 WATERFORD CT 06385-4332 860-443-5822

1285046359 LONDONO TOBON AMALIA 300 GEORGE STREET YALE PSYCHIATRY SUITE 901 NEW HAVEN CT 06511-6664 203-785-2095

1265487482 LONGLEY MICHAEL 2600 BRUCE B DOWNS BLVD WESLEY CHAPEL FL 33544-9207 800-645-3055

HUSKY Health Connecticut Page 36 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 37: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1588717524 LONGO CRAIG 101 PAGE STREET NEW BEDFORD MA 02740-3464 508-973-3584

1821183377 LONGO MICHAEL 310 MAIN STREET LLA EAST HAVEN CT 06512-2919 203-468-7181

1639407513 LOPER COURTNEY 300 LONGWOOD AVE BOSTON MA 02115-5724 617-355-8537

1255314746 LOPEZ CARMEN VILLAS DE RIO GRANDE CALLE 4 L 1 RIO GRANDE PR 00745-2824 787-888-7336

1609094549 LOREFICE LAURENCE 1443 EAST PUTNAM AVE OLD GREENWICH CT 06870-2222 203-637-4006

1629043963 LOTA CONRADO 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1598702326 LOUDERMILK ANN 55 FOGG ROAD WEYMOUTH MA 02190-2432 781-624-3889

1881744456 LOUIT AYMERIC 148 EAST AVENUE SUITE 3G NORWALK CT 06851-5727 203-838-4034

1578551040 LOULOUDES JENNIFER 119 BELMONT STREET UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01605-2903 508-334-8515

1154413615 LOVEJOY GLEN 29 LEWIS AVE GREAT BARRINGTON MA 01230-1713 413-447-2752

1962400200 LOWNEY MARK 363 HIGHLAND AVE FALL RIVER MA 02720-3703 508-973-3584

1134212798 LUCAS CYNTHIA 3350 MAIN STREET SPRINGFIELD MA 01199-1619 413-794-9338

1093966954 LUCCHI NORA ANN 200 SANDY HOLLOW ROAD MYSTIC CT 06355-1720 860-536-4916

1801012075 LUCK LEON 34 MAPLE ST NORWALK CT 06850-3815 203-227-0837

1215003272 LUGO KATIA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1639209398 LUGO RAQUEL 1000 SILVER STREET MIDDLETOWN CT 06457-7203 860-262-5000

1174877971 LUKASZEWICZ MAGDALENA 23 CEDAR STREET NEW BRITAIN CT 06052-1301 860-827-0071

1528016441 LUM JO 1 LONG WHARF DE STE 212 NEW HAVEN CT 06511-5593 203-624-4208

1538422852 LUONGO ANN CATHOLIC CHARITIES 151 BROAD STREET MIDDLETOWN CT 06457-3327 860-342-0760

1922087832 LYNCH DARREN 395 PLEASANT ST NORTHAMPTON MA 01060-3914 413-584-7787

1275557019 LYNCH DAVID 15 OLD PARK LANE NEW MILFORD CT 06776-2507 860-354-3632

1922041094 LYNCH MICHAEL 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1578971370 LYNDON STANLEY 300 GEORGE STREET YALE PSYCHIATRY NEW HAVEN CT 06511-6664 203-785-2095

1992968028 MAALOUFCHAHDA GRACIELA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1144333121 MACCHIAROLI RICHARD 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1750371811 MACDONALD JEANNE 55 FRUIT ST BOSTON MA 02114-2696 617-724-9040

1598074924 MACDONALD MORAG 401 WEST THAMES ST BLDG 301 NORWICH CT 06360-7167 860-859-4674

1114995115 MACHATA KARL 111 BREWSTER STREET PAWTUCKET RI 02860-4474 401-273-0641

1154429413 MACHLEDT JOHN 65 BEERS RD EASTON CT 06612-1758 203-268-8737

1497866875 MACKEY JENNIFER 423 LONG HILL RD. GROTON CT 06340-3812 860-449-8330

1245258441 MACKIE JR W ANDREW 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-443-7552

1740342013 MACKINTOSH BARBARA 12 SANDPIPER CRESCENT MILFORD CT 06460-7951 203-257-1851

1700932258 MACKLER FREDERIC 46 DAGGETT DRIVE SUITE 2C WEST SPRINGFIELD MA 01089-4646 413-747-9224

1528153236 MADAN ATUL 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1740260058 MAGALDI JOHN 538 LITCHFIELD ST SUITE 101 TORRINGTON CT 06790-6669 860-496-4085

1093037103 MAGARINOLIRIANO JANETTE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1073638169 MAGGIORE LISA 40 CROSS STREET SUITE 300 NORWALK CT 06851-4661 203-845-2995

1063438612 MAGNUS PATRICK 246 PLEASANT STREET SUITE 103 CONCORD NH 03301-2548 603-224-6070

1508067109 MAGRAS LAWRENCE 11 FAIRFIELD BLVD WALLINGFORD CT 06492-1828 203-949-4000

1417251513 MAHFOUD JOSE 60 LAFAYETTE STREET SUITE 633 BRIDGEPORT CT 06604-5462 203-576-0345

1487894986 MAHONEY WEST HELEN 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1063533750 MAHONY ELLEN 131 KINGS HIGHWAY NORTH WESTPORT CT 06880-2429 203-221-0102

1255696068 MAITOZA LAURA 20 YORK STREET YNHH - DEPT PED CARD NEW HAVEN CT 06510-3220 203-688-4242

HUSKY Health Connecticut Page 37 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 38: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1265849202 MAJCHER-TASCIO MAGDALENA 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1174825814 MAJEED MUHAMMAD 189 STORRS RD, MANSFIELD CENT CT 06250-1683 860-456-1311

1194168005 MAKSIMOWSKI MICHAEL 20 YORK STREET YNHH FITKIN 6 NEW HAVEN CT 06510-3229 203-785-2618

1407845332 MALANE MICHELLE 1781 HIGHLAND AVENUE CHESHIRE CT 06410-1254 203-272-3376

1568894293 MALDONADO CATHERINE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1295830784 MALEN RICHARD 17 E 96TH ST #1A NEW YORK NY 10128-0783 212-722-5080

1245321553 MALINA ALAN 95 SCOVILL STREET WATERBURY VA PRIMARY CARE CENT WATERBURY CT 06706-1113 203-932-5711

1083649933 MALISON ROBERT 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016

1659481166 MALONEY ANN 336 THOMPSON ROAD WEBSTER MA 01570-1587 508-765-2202

1285677674 MANADAN PAUL 7031A 108TH ST STE 7 FOREST HILLS NY 11375-4450 646-397-3343

1225364557 MANCA LISA 20 YORK STREET, CB-2041 NEW HAVEN CT 06510-3220 203-688-1734

1245465442 MANDALAYWALA DHANSUKHLAL 185 W. MAIN STREET DUDLEY MA 01571-3819 508-943-9147

1134292881 MANDARA MDMD SILVIO 27 OAK STREET STAMFORD CT 06905-5342 203-324-2262

1932483658 MANDEL DOLORES 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016

1215075908 MANDELBAUM CHAIM 10 UNION SQUARE EAST SUITE 4K NEW YORK NY 10003-3314 646-602-8030

1275601106 MANEVICH NATALIA 1635 CENTRAL AVENUE BRIDGEPORT CT 06610-2717 203-551-7400

1528152113 MANGAN PATRICIA CHILDREN'S & WOMAN'S PHYSICI 10 WEATHERVANE DR. WASHINGTONVILLE NY 10992-2242 914-922-2241

1699145789 MANN CHRISTA 20 YORK STREET NEW HAVEN CT 06510-3202 203-688-6545

1518989789 MANNING CAROL 400 BALD HILL ROAD WARWICK RI 02886-1692 401-384-6444

1922061647 MANNING DANA 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1164667929 MANNING TIA 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1164608154 MANNING, D.O. LYNNE 1000 SILVER STREET BOX 351 MIDDLETOWN CT 06457-7023 860-262-5868

1083896906 MANNION MICHELE 3423 DANBURY ROAD BREWSTER NY 10509-4513 845-279-7200

1932212982 MANOLIO RICHARD 736 N BATTLEFIELD BLVD CHESAPEAKE VA 23320-4941 800-633-2243

1891921169 MANSFIELD OMAYRA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1184638157 MANTIKAS GEORGE 142 EAST HIGH ST EAST HAMPTON CT 06424-1545 860-267-6666

1194899351 MANZO RICHARD 1320 WEST MAIN STREET BLDG 2 WATERBURY CT 06708-3123 203-755-7115

1851479844 MARACHI JEAN 167 OLD POST ROAD SOUTHPORT CT 06890-1395 203-259-1059

1790746907 MARCOUX PAUL 450 BROOKLINE AVENUE DANA FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1639226566 MARCUS KENNETH 1 BRADLEY RD. SUITE 703 WOODBRIDGE CT 06525-2235 203-772-0003

1679597744 MARCUS NORMAN 30 E. 40TH STREET STE 1100 NEW YORK NY 10016-1203 212-532-7999

1366512402 MARGOULEFF DONALD 39-31 211TH STREET BAYSIDE NY 11361-1957 718-428-1011

1548209661 MARINACCIO BARBARA 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-919-7309

1366418758 MARINGOLA JR RONALD 111 WEST MAIN STREET MERIDEN CT 06451-4141 203-237-6325

1235283243 MARINI LUCIANO 26 LAKESIDE BLVD EAST WATERBURY CT 06708-2916 203-575-9097

1437183266 MARK JENNIFER 575 BEECH STREET HOLYOKE MA 01040-2223 215-442-5089

1639178346 MARKEY PAUL 40 CROSS STREET SUITE 300 NORWALK CT 06851-4661 203-845-2995

1265843718 MARKO STEPHEN 20 YORK STREET YNHH EMERGENCY MEDICINE NEW HAVEN CT 06510-3220 203-737-2644

1225057714 MARKOWITZ KIRSTEN 40 HART STREET NEW BRITAIN CT 06052-1743 860-225-1227

1194128637 MARKS BRIENNE 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-8853

1982770145 MARKS LAURA 1563 POST ROAD EAST WESTPORT CT 06880-5602 203-319-3939

1720344187 MARLOW JOHN C/O CENTER FOR OPTIMUM HEALTH 172 EAST AVENUE NEW CANAAN CT 06840-5615 203-972-0402

1154354256 MAROLDA THEODORE 16 HINSDALE AVE. WINSTED CT 06098-1108 860-379-7198

1073550307 MAROTTA ROCCO 9 KEELER COURT RIDGEFIELD CT 06877-1000 732-828-0361

HUSKY Health Connecticut Page 38 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 39: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1144515917 MARQUES ANDRE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1083612527 MARQUEZ LUIS 1306 FERNANDEZ JUNCOS AVENUE SAN JUAN PR 00907-4127 787-480-3000

1861662975 MARRERO-STEIN MARGOT CHILDREN'S & WOMENS PHYSICIAN 503 GRASSLANDS RD VALHALLA NY 10595-1503 914-304-5313

1780978114 MARSHALL JEFFREY 20 YORK STREET YNHH DEPARTMENT OF MEDICINE NEW HAVEN CT 06510-3220 203-688-9503

1174771752 MARTI CANDICE 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1841629482 MARTIN DANIELLE 119 BELMONT STREET UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01605-2903 508-334-8515

1316299704 MARTIN JULIE 1 TOWNE PARK PLAZA NORWICH CT 06360-2559 317-509-3900

1831276021 MARTINS SUSAN 170 HAZARD AVE ENFIELD CT 06082-4520 860-749-2022

1992919187 MARTINUCCI ERICA 1981 EAST MAIN ST WATERBURY CT 06705-1822 203-709-6794

1235303058 MARTUFI CYNTHIA 11 FRIENDSHIP STREET NEWPORT RI 02840-2209 401-444-4171

1568705978 MARUCA SULLIVAN PHELAN 20 YORK STREET YNHH TOMPKINS 2 -- RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1205873783 MARZITELLI KAREN 950 CAMPBELL AVE WEST HAVEN CT 06516-2700 866-808-7921

1669403820 MASCARDO RENATO 598 DANBURY ROAD RIDGEFIELD CT 06877-2178 203-431-0280

1437133154 MASI ANTHONY 4699 MAIN STREET SUITE 106 BRIDGEPORT CT 06606-1830 203-374-8182

1427219765 MASKARA PAMELA ONE TURKEY HILL RD SOUTH WESTPORT CT 06880-5525 203-227-7530

1215953567 MASON DAVID 736 IRVING AVENUE SYRACUSE NY 13210-1690 800-645-3055

1568627917 MASTERSON LARRY 701 ENFIELD STREET ENFIELD CT 06082-2967 860-741-6572

1740230358 MASTINO CHRISTOPHER 1261 POST ROAD SUITE 200 FAIRFIELD CT 06824-6072 203-292-6694

1073539367 MASTROIANNI PATRICK 340 CAPITOL AVENUE BRIDGEPORT CT 06606-5412 203-336-3303

1699979542 MATERN ELIZABETH 20 WEST MAIN STREET SECOND FLOOR AVON CT 06001-3716 860-470-7909

1306010129 MATHEW THOMAS 500 CHASE PKWY WATERBURY CT 06708-3346 203-755-6677

1073683280 MATHIAS TAMAR 84 HOSPITAL AVENUE DANBURY CT 06810-6047 203-792-0400

1336260512 MATROS EVAN 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1306237599 MATTHEWS JOHN 55 FRUIT ST BOSTON MA 02114-2696 617-724-4100

1992870638 MATULONIS URSULA 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1104945708 MATYAS JANELLEN 4 SHAWS COVE #202 NEW LONDON CT 06320-4902 860-443-4199

1407144710 MAUER SUSAN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1609821073 MAUREAU MICHELLE 64 ROBBINS STREET WATERBURY CT 06708-2613 215-442-5046

1518187533 MAVOR ANNE 5151 PARK AVENUE FAIRFIELD CT 06825-1111 203-371-7838

1831531334 MAXWELL LINDA 300 BOSTON POST ROAD HEALTH SERVICES WEST HAVEN CT 06516-1916 203-932-7079

1861669814 MAYBERG STEPHANIE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-8152

1386630085 MAYER FERN 132 MORGAN STREET STAMFORD CT 06905-5431 203-969-0123

1659361327 MAYER ROBERT 450 BROOKLINE AVENUE, LW205 DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1407882921 MAYMAN DAVID 535 E. 70TH STREET NEW YORK NY 10021-4823 646-797-8471

1083708945 MAZEIKA CAMDEN 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1033176896 MC ALLISTER PETER 30 BUXTON FARMS ROAD SUITE 230 STAMFORD CT 06905-5362 203-914-1900

1568413326 MCALLISTER SARAH 52 BEACH RD FAIRFIELD CT 06824-5663 203-254-2000

1760607659 MCATEER KRISTINA 455 TOLLGATE ROAD WARWICK RI 02886-2759 401-273-0641

1649492752 MCBEAN JASON 1305 POST RD STE 310 FAIRFIELD CT 06824-6016 203-259-7709

1285682948 MCCABE BARBARA 1169 ELLINGTON ROAD SOUTH WINDSOR CT 06074-3515 860-757-3220

1306094396 MCCABE BARBARA 98 S. MAIN ST NORWALK CT 06854-3126 203-899-2494

1437416898 MCCAFFREY RYAN ONE GENERAL STREET LAWRENCE MA 01841-2961 978-683-4000

1164401493 MCCARTHY CHRISTINE 185 BIRCH STREET WILLIMANTIC CT 06226-2295 860-465-0185

1427022565 MCCARTIE JOHN CROTCHED MOUNTAIN REHAB CTR ONE VERNEY DRIVE GREENFIELD NH 03047-5000 603-547-3311

HUSKY Health Connecticut Page 39 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 40: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1376955047 MCCARTY THOMAS 20 YORK STREET YNHH INTERNAL MEDICINE NEW HAVEN CT 06510-3220 203-688-9503

1154500981 MCCARVELL KATHLEEN 189 STORRS RD MANSFIELD CENTER CT 06250-1683 860-908-3082

1356573265 MCCLOSKEY LUANNE 2 MEDICAL CENTER DRIVE STE 309 BAYSTATE MEDICL PRACTICES SPRINGFIELD MA 01199-1619 413-794-5363

1760793863 MCCORMICK CHRISTINA 1 RIVER STREET THUNDERMIST HEALTH CENTER WAKEFIELD RI 02879-3214 401-767-4100

1477648285 MCCOWAN PATRICIA 281 LINCOLN STREET WORCESTER MA 01605-2138 508-793-6348

1760773287 MCDOUGALL JOHN 20 YORK STREET YNHH TOMPKINS 226 NEW HAVEN CT 06510-3220 203-688-9503

1376947432 MCDOWELL ANDREW 1 LONG WHARF DR STE 212 NEW HAVEN CT 06511-5593 203-617-0691

1063628295 MCFARLAND WARD 527 TUNXIS HILL RD INTEGRATED MEDICAL CENTER OF F FAIRFIELD CT 06825-4473 203-333-7788

1689634115 MCGINNIS DAVID 43 HIGH STREET EMERGENCY DEPARTMENT WAREHAM MA 02571-2097 508-973-3584

1861473431 MCGLASHAN THOMAS 34 PARK ST. NEW HAVEN CT 06519-1109 203-974-7016

1023009230 MCGOLDRICK PATRICIA 141 SOUTH CENTRAL PARK AVENUE HARTSDALE NY 10530-2340 914-428-0529

1265450936 MCGONAGLE JAN CMRC ONE VERNEY DRIVE GREENFIELD NH 03047-5000 603-547-3311

1770034746 MCGRATH MEGAN 189 STORRS RD MANSFIELD CENTER CT 06250-1683 860-465-5904

1861940090 MCGROARTY JESSICA 84 HOSPITAL AVENUE DANBURY CT 06810-6047 203-792-0400

1376863803 MCKENNA CHRISTEN 1600 S ANDREWS AVE FORT LAUDERDALE FL 33316-2510 954-847-4572

1770898694 MCKENNA JENNIFER 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1669674750 MCKENNA MAUREEN CHILDREN'S & WOMAN'S PHYSICI 10 WEATHERVANE DR. WASHINGTONVILLE NY 10992-2242 914-922-2241

1518376425 MCKEON SEAN 1635 CENTRAL AVE FAIRFIELD CT 06824-3866 203-551-7502

1437413085 MCLAIN BARBARA CHILDREN'S & WOMENS PHYSICIAN 19 BRADHURST AVE., SUITE 1400 HAWTHORNE NY 10532-2144 914-493-7997

1629368188 MCLAIN JOHN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1386683555 MCLAUGHLIN CAROLYN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1669518932 MCLAUGHLIN KEVIN 148 EAST AVENUE SUITE2F NORWALK CT 06851-5726 203-866-0061

1215919782 MCLAUGHLIN SUZANNE 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-6484

1881726123 MCLENNON DANIEL 16 LAKE ST. COVENTRY CT 06238-0327 860-742-0539

1619315637 MCLIMANS SHARON 1 RIVER STREET THUNDERMIST HEALTH CENTER WAKEFIELD RI 02879-3214 401-767-4100

1144331166 MCNAMARA CYNTHIA 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2770 203-932-5711

1780088138 MCNAMARA REGINA 1635 CENTRAL AVENUE BRIDGEPORT CT 06610-2700 203-551-7627

1780946715 MCPADDEN JACOB 20 YORK STREET YNHH DEPT OF PEDIATRICS NEW HAVEN CT 06510-3220 203-688-9503

1831282284 MCSHANE KEVIN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1033485263 MECCA ADAM 300 COLLEGE STREET SUITE 901 NEW HAVEN CT 06511-3200 203-785-2095

1528168879 MECKEL MARIE 11 WILBRAHAM RD SPRINGFIELD MA 01199-1619 413-794-3710

1538207147 MEGIBOW CRAIG 300 FEDERAL ROAD STE 103 BROOKFIELD, CT 06804-2412 203-775-1800

1710936414 MEHIGAN JENNIFER 300 LONGWOOD AVE BOSTON MA 02115-5724 617-919-7307

1437134426 MEHRARA BABAK 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1265489033 MEJNARTOWICZ SLAWOMIR 55 LOCK STREET NEW HAVEN CT 06511-2837 203-432-0075

1215153267 MELAMED JOEL 1461 SOUTH BRITAIN ROAD COTTAGE 3 SOUTHBURY CT 06488-0901 203-586-2000

1891059739 MELENDEZ MAELISA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1447379516 MELTZER STEVEN 3 NORTHWESTERN DRIVE BLOOMFIELD CT 06002-3465 860-242-5594

1366784647 MENDIOLA FRANKIE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1205823796 MENDOZA GLENN CHILDREN''S & WOMAN''S PHYSICI 45 READE PL POUGHKEEPSIE NY 12601-3947 914-922-2241

1063621506 MENNESSON MICHEL 42 JARVIS ST CHESHIRE CT 06410-1503 203-806-2544

1013240035 MERCADO RONNIEL 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1518095645 MERCADO VANESSA CHILDREN'S & WOMAN'S PHYSICI 701 N BROADWAY SLEEPY HOLLOW NY 10591-1020 914-922-2241

1053336818 MERER MICHELLE CHILDREN'S & WOMENS PHYSICIAN 1075 CENTRAL PARK AVE, SCARSDALE NY 10583-3237 914-475-4300

HUSKY Health Connecticut Page 40 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 41: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1407072838 MERRIAM PRISCILLA DANA FARBER CANCER INSTITUTE 450 BROOKLINE AVENUE BOSTON MA 02215-5418 617-632-5917

1467771857 MERRITT RAYMOND 2600 BRUCE B DOWNS BLVD WESLEY CHAPEL FL 33544-9207 800-645-3055

1023280328 MERTZ CHRISTOPHER 250 PLEASANT STREET CONCORD NH 03301-2598 603-227-7000

1881771574 MESSINA DINO 111 BREWSTER ST. PAWTUCKET RI 02860-4474 401-729-2000

1790704690 MESSING BLAINE 115 FILLOW STREET, SUITE 30 BLAINE E. MESSING,MD,MSW,LLC NORWALK CT 06850-2840 203-505-1492

1144662156 MEUNIER SUSAN CAPITOL REGION M. HLTH CENTER 500 VINE STREET HARTFORD CT 06112-1639 860-297-0909

1659748028 MEYER SARA 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-338-6600

1710053939 MEYERS JOHN CAPITOL REGION MENTAL HEALTH C 500 VINE STREET HARTFORD CT 06112-1639 860-297-0999

1689931131 MICHAEL SEAN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1902834369 MICHAELIS JEFFREY 3423 DANBURY ROAD BREWSTER NY 10509-4513 845-279-7200

1508898800 MICHAELSON GRETCHEN 144 MAIN STREET SUITE D EAST HARTFORD CT 06118-3239 860-895-3133

1659464386 MICHALAKES CHRIS 6 GLEN COVE DR. ROCKPORT ME 04856-4240 623-241-8321

1093752214 MICHELMAN THOMAS 29 LEWIS AVE GREAT BARRINGTON MA 01230-1713 413-447-2752

1023274552 MICHNA ISABELLA 1000 SILVER STREET BOX 351 MIDDLETOWN CT 06457-7023 860-262-5000

1376539205 MICKLEY STEVEN 7 RIVERSVILLE ROAD GREENWICH CT 06831-3627 203-531-1808

1306939087 MIESZCZANSKI MELISSA 130 DIVISION ST DERBY CT 06418-1326 616-464-0027

1679740542 MIFSUD ANTHONY 100 PARK STREET GLENS FALLS NY 12801-4413 801-256-1900

1285835918 MIKAIEL MAGDY 1625 STRAITS TURNPIKE MIDDLBURY CT 06762-1836 203-598-3889

1225046022 MIKAITIS DAWN 207 MEADOW STREET NAUGATUCK CT 06770-4003 203-729-9248

1912915968 MILES DANIEL 223 EAST 34TH ST. NEW YORK NY 10016-4852 646-558-0859

1124129226 MILES MELISSA 11 WILBRAHAM ROAD SPRINGFIELD MA 01109-3161 413-794-3710

1790773257 MILLARD CHRISTOPER 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1437356706 MILLER CALVIN PAMELA ROBUSTELLO 75 SEMINARY HILL RD CARMEL NY 10512-1921 845-225-3400

1205810272 MILLER CHADWICK MEDICAL CENTER BLVD WINSTON SALEM NC 27157-0001 336-713-4944

1184692162 MILLER JEFFREY 6 SHAWS COVE SUITE 101 NEW LONDON CT 06320-4969 860-444-9022

1578534640 MILLER JEFFREY 538 LITCHFIELD ST SUITE 101 TORRINGTON CT 06790-6669 860-496-4085

1881631000 MILLER KENNETH 800 WASHINGTON STREET BOSTON MA 02111-1526 617-636-5000

1558380345 MILLER LYNNE 1663 ROUTE 22 STE B5 BREWSTER NY 10509-4050 845-278-7107

1699900126 MILLER MIRYAM 3001 BROADMOOR BLVD NE RIO RANCHO NM 87144-2100 505-272-3295

1861500704 MILLER NORA 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1336255470 MILLER PAUL 258 MAIN AVE NORWALK CT 06851-2748 203-846-3424

1437266079 MILLIKEN LAURA 100 HAYNES STREET,2ND FLOOR DEQUATTRO CANCER CENTER MANCHESTER CT 06040-4113 860-533-3091

1487696282 MILLMAN ERIC 64 TRUMBULL STREET NEW HAVEN CT 06510-2118 203-865-1390

1396914016 MILLS ANTHONY 4000 WELLNESS DRIVE MIDLAND MI 48670-0001 800-645-3055

1487689170 MINER CHARLES 1500 POST ROAD DARIEN CT 06820-5935 203-655-8749

1679538334 MINTZ ABRAHAM 5520 PARK AVENUE SUITE 210 TRUMBULL CT 06611-3465 203-372-6460

1083682082 MINTZ JOSHUA 1400 STATE ST SPRINGFIELD MA 01109-1671 413-726-6702

1043291107 MISRA MADHUSMITA 55 FRUIT ST YAW 6 BOSTON MA 02114-2696 617-726-2909

1699801431 MITCHELL DEBORAH MASSACHUSETTS GENERAL HOSPITAL 55 FRUIT ST BOSTON MA 02114-2621 617-643-0711

1235277161 MITCHELL MARY ELLEN CHILDREN''S & WOMENS PHYSICIAN 755 NORTH BROADWAY SLEEPY HOLLOW NY 10591-1076 914-366-3400

1033209317 MITCHELL PATRICIA 736 IRVING AVENUE SYRACUSE NY 13210-1690 800-645-3055

1912108994 MITCHELL RACHEL 1084 CROMWELL AVENUE ROCKY HILL CT 06067-3445 860-721-7561

1962705236 MITCHELL-BOUDREAU CAROL THE NEW ENGLAND CENTER FOR CHI 33 TURNPIKE ROAD SOUTHBOROUGH MA 01772-2108 508-481-1015

1316006638 MODESTO LOWE VANIA 1000 SILVER STREET CONNECTICUT VALLEY HOSPITAL MIDDLETOWN CT 06457-7023 860-262-5868

HUSKY Health Connecticut Page 41 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 42: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1679561831 MOGELOF ANDREW 2499 MAIN STREET STRATFORD CT 06615-5843 203-378-5588

1568461465 MOHREN GRAVES SHIRLEY NATCHAUG HOSPITAL 189 STORRS RD MANSFIELD CENTER CT 06250-1683 860-456-1311

1205800463 MOHRER PETER 5 DURHAM RD SUITE 5B GUILFORD CT 06437-2076 203-453-4870

1669602835 MOISAN JOSEPH 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-8692

1659565216 MOJCIK CHRISTOPHER 3203 MAIN STREET BRIDGEPORT CT 06606-4225 203-371-0009

1659564318 MOLINS CAROLINE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1164406823 MOLL JOEL 1250 E MARSHALL ST RICHMOND VA 23298-5051 800-645-3055

1841673837 MONAST KEISHA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1598857997 MONI JANAKI 55 LAKE AVENUE, NORTH WORCESTER MA 01655-0002 508-334-8890

1396972527 MONROE JENNIFER 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1518057942 MONSARRAT MICHAEL 37 N. MAIN ST KENT CT 06757-0268 860-927-3519

1780761528 MONTELEONE VIRGILLIO CHILDREN'S & WOMAN'S PHYSICIAN 263 N. BREWSTER RD BREWSTER NY 10509-2844 914-922-2241

1225006877 MONTI JAMES 593 EDDY STREET CLAVERICK 2 PROVIDENCE RI 02903-4923 401-854-2504

1245490374 MOON CAROLINE CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 2400 HAWTHORNE NY 10532-2144 914-922-2241

1447412804 MOONEY TIMOTHY 1101 NOTT ST SCHENECTADY NY 12308-2425 801-256-1900

1174566848 MOORADIAN CHRISTOPHER 377 COLMAN STREET NEW LONDON CT 06320-3743 860-444-6363

1336325596 MOORCROFT JILL 279 NEW BRITAIN RD #6 BERLIN CT 06037-3165 860-438-7096

1598941585 MOORCROFT THOMAS 279 NEW BRITAIN RD #6 BERLIN CT 06037-3165 860-438-7096

1588700538 MOORE EILEEN 108 NEW LONDON TPKE. NORWICH CT 06360-2645 860-889-3052

1285717009 MOORE PAMELA CONNECTICUT VALLEY HOSPITAL 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1366884579 MORAMONTERO CLARA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1033260310 MORAN BRETE 5 SOUTH MAIN STREET BRANFORD CT 06405-3845 203-483-8656

1518306638 MORANT RICARDO 1358 BOSTON POST RD OLD SAYBROOK CT 06475-6475 860-388-3522

1467574582 MORELLI MARIANNE 834 FEDERAL ROAD, SUITE A BROOKFIELD CT 06804-2324 203-775-6167

1457653123 MORGAN ANN 300 LONGWOOD AVE BOSTON MA 02115-5724 617-355-8537

1609804905 MORGAN HARRY 55 NYE ROAD SUITE 102 GLASTONBURY CT 06033-1281 860-657-3056

1225285430 MORGAN HEATHER 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-443-7552

1497714570 MORGAN JEFFREY 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1578708111 MORGENTHALER DIANE SCSU GRANOFF HALL 10 WINTERGREEN AVENUE NEW HAVEN CT 06515-1355 203-392-6300

1215265582 MORIN DANIEL 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1619217072 MORIN LINDSEY 40 WRIGHT STREET PALMER MA 01069-1138 413-284-5400

1760628341 MORINIAUX SYLVIE 6401 N FEDERAL HWY FORT LAUDERDALE FL 33308-1427 623-580-6309

1467444562 MORMILE JOHN 234 MAIN ST PORTLAND CT 06480-1861 860-342-7277

1184673188 MOROCZ DIANA 1040 BARNUM AVENUE MED NOW, P.C. STRATFORD CT 06614-4968 203-377-5733

1366561201 MORRIS JEFFREY 3 NORTHWESTERN DRIVE BLOOMFIELD CT 06002-3465 860-242-5594

1811018401 MORTON LOIS 2 BENEDICT PLACE GREENWICH CT 06830-5358 203-622-6551

1487671962 MOSKOVITZ ANDREW 2150 MAIN STREET SPRINGFIELD MA 01104-3300 860-741-6572

1881850626 MOSKOWITZ ALISON 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1821397704 MOY MATTHEW 55 FRUIT ST BOSTON MA 02114-2696 617-726-7717

1891851739 MOZZICATO SEBASTIAN SILVER STREET MIDDLETOWN CT 06457-7744 860-262-5358

1316205719 MUCARIA DANETTE 291 LINCOLN STREET MCPAP WORCESTER MA 01605-3643 508-334-6556

1295722031 MUEHLBERG AMI 215 TOLL GATE ROAD WARWICK RI 02886-2759 401-273-0641

1497763080 MUELLER FRIEDRICH 999 SUMMER STREET SUITE 200 STAMFORD CT 06905-9998 203-357-7773

1972693711 MUGGIA VICTORIA 111 EAST 210 STREET DTC-3 BRONX NY 10467-2490 718-920-5439

HUSKY Health Connecticut Page 42 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 43: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1366477408 MULHERON MARILYNN 29 LEWIS STREET GREAT BARRINGTON MA 01230-1713 413-881-3427

1043242134 MULLEN DAVID 16 SUNNY VALLEY RD NEW MILFORD CT 06776-3323 860-354-1400

1790710986 MULLEN JOHN 131 KENT ROAD NEW MILFORD CT 06776-3485 203-702-6640

1437239704 MULLEN PETER 16 SUNNY VALLEY RD NEW MILFORD CT 06776-3323 860-354-1400

1023409596 MULLER BRIANNA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1881920205 MUMLEY KATE 119 BELMONT STREET UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01605-2903 508-334-6477

1104266428 MUNJAL SAHIL 20 YORK STREET YNHH FITKIN 6 NEW HAVEN CT 06510-3220 203-785-2618

1750556353 MURPHY CASSANDRA 555 WILLARD AVE NEWINGTON CT 06111-2631 203-932-5711

1194777557 MURPHY DANIEL 4422 3RD AVE BRONX NY 10457-2545 800-645-3055

1760927552 MURPHY MICHELLE 130 DIVISION ST DERBY CT 06418-1326 203-732-7541

1689883837 MURTY DEIRDRE 324 ELM STREET MONROE CT 06468-3244 203-216-4906

1376595868 MUSHAWEH JAROB 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1609972538 MYER JENNIFER 261 BRADLEY STREET 3RD FLOOR NEW HAVEN CT 06510-1104 203-752-1733

1750324356 MYERS-ALBARIDI ERIN 761 MAIN AVE SUITE 102 NORWALK CT 06851-0001 860-282-4133

1356507933 NA MICHELLE 2 POMPERAUG OFFICE PARK SOUTHBURY CT 06488-2288 203-264-1620

1346230521 NACHTIGALL LISA ZERO EMERSON PLACE STE 112 BOSTON MA 02114-2217 617-726-7948

1154320174 NACKENSON MARCIA CHILDREN'S & WOMAN'S PHYSICI 503 GRASSLANDS RD VALHALLA NY 10595-1593 914-922-2241

1861400814 NADKARNI SIDDHARTHA 223 EAST 34TH ST NEW YORK NY 10016-4852 631-232-4260

1366535163 NAGALLA BHAVANI VA CONNECTICUT HEALTH CARE 555,WILLARD AVE NEWINGTON CT 06111-2600 860-666-6951

1548242647 NAHM FREDERICK 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1659593317 NAKIC MARINA 1000 SILVER STREET MIDDLETOWN CT 06457-7203 860-262-5000

1548454622 NALLY JENNIE 761 MAIN AVE SUITE 102 NORWALK CT 06851-0001 860-282-4133

1356451173 NAPLES ROBIN 3401 N. BROAD ST PHILADELPHIA PA 19140-5103 623-580-6309

1952355174 NAPOLI ANTHONY 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1194861609 NARAD JOAN 7 NORTH COVE ROAD OLD SAYBROOK CT 06475-2538 860-304-2049

1841249331 NARADZAY JEROME 2215 BURDETT AVE TROY NY 12180-2466 518-271-3450

1366441933 NATHAN PRAMILA 204 CHERRY ST MILFORD CT 06460-3555 203-876-0545

1134133804 NATHANSON ANDREW 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1568481877 NATHANSON ROBERT 61 SOUTH MAIN ST SUITE 309 WEST HARTFORD CT 06107-2403 860-561-1350

1740417468 NATHENSON MICHAEL DANA-FARBER CANCER INSTITUTE 450 BROOKLINE AVE BOSTON MA 02215-5450 617-632-5204

1306936851 NAVIN MARK 157 UNION STREET MARLBOROUGH MA 01752-1228 508-793-6348

1891953196 NAYAK LAKSHMI 450 BROOKLINE AVE DA2108A BOSTON MA 02215-5450 617-632-3965

1558461087 NAYOWITH BRUCE 29 LEWIS AVE GREAT BARRINGTON MA 01230-1713 413-447-2752

1396803649 NAZARETH LUMINA 1635 CENTRAL AVENUE BRIDGEPORT CT 06610-2717 203-551-7400

1891783361 NAZARIO STEVEN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1629379631 NAZARIO VANESSA 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-224-5438

1891728853 NEGBENEBOR DARLENE 1450 WASHINGTON BLVD STAMFORD CT 06902-2451 914-401-8031

1306889167 NEGRON CYNTHIA 55 LOCK STREET NEW HAVEN CT 06511-3603 203-432-0076

1740220714 NELKEN MICHAEL 117 ALSTON AVE NEW HAVEN CT 06515-2001 203-387-0260

1598760522 NELSON HEIDI 45-12 41ST STREET SUNNYSIDE NY 11104-3419 718-784-2699

1881618304 NELSON JONATHAN 33 CEDAR STREET RYE NY 10580-2031 914-921-4874

1720208200 NELSON PETER 717 NEWFIELD STREET MIDDLETOWN CT 06457-1815 860-347-1227

1790055168 NELSON PHILLIP 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1912938473 NESPOLI MARC 7 GERMANTOWN RD DANBURY CT 06810-5033 203-798-8422

HUSKY Health Connecticut Page 43 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 44: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1821293515 NESSELROADE RYAN 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1255345179 NESTOR ELIZABETH 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1144342528 NEU JANE 185 BIRCH STREET WILLIMANTIC CT 06226-2295 860-465-5263

1336161660 NEUHAUS DAVID 71 HAYNES ST MILLER BLDG EASTERN CT MEDICAL PROFESSIONA MANCHESTER CT 06040-4131 860-646-1222

1316267479 NEUPANE BHUSAN 20 YORK STREET TOMPKINS, 209 NEW HAVEN CT 06510-3202 203-688-9503

1801816798 NEUREITHER LAWRENCE 573 HOPMEADOW STREET SIMSBURY CT 06070-2462 860-658-0010

1457678286 NEWBERRY MARK 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1801249057 NEWCOMER MEGHAN 1 HOSPITAL PLAZA STAMFORD HOSPITAL STAMFORD CT 06902-3602 646-797-8471

1992720114 NEWFIELD PHILIP CHILDREN'S & WOMAN'S PHYSICI 422 WESTERN HWY TAPPAN NY 10983-1311 914-922-2241

1053421834 NEWMEYER MICHELE 171 RAMAPO RD GARNERVILLE NY 10923-1552 914-922-2241

1558781039 NG STEPHANIE 300 GEORGE STREET YALE PSYCHIATRY NEW HAVEN CT 06511-6663 203-785-2095

1376505867 NICHOLLS CHAD 3460 SOUTH PIONEER PARKWAY WEST VALLEY CITY UT 84120-2049 615-467-1238

1427016013 NICOLETTI MARK 725 NORTH ST. BERKSHIRE MEDICAL CENTER PITTSFIELD MA 01201-4132 413-447-2752

1902813587 NICOLETTI VALERIE 725 NORTH STREET PITTSFIELD MA 01201-4019 413-881-5427

1336278043 NIELDS JENIFER 108 OLD ORCHARD PARK FAIRFIELD CT 06824-6606 203-259-5812

1558394833 NIHARIKA MEHTA 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1861568552 NIKOLOV ROUMEN 44 STRAWBERRY HILL AVE SUITE 2 STAMFORD CT 06902-2632 203-820-3224

1518901552 NOBLE JAMES 246 PLEASANT STREET SUITE 104 CONCORD NH 03301-2548 603-230-1939

1356478408 NOCHIMSON DAVID 15 DONAHUE RD N.GRANBY CT 06060-1404 860-653-3466

1346579471 NOE PATRICIA 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-441-6767

1104016823 NOLAN SHEILA 19 BRADHURST AVE STE 1400 HAWTHORNE NY 10532-2144 914-922-2241

1700900792 NORIGE KEVIN 112 DEMING ST. SOUTH WINDSOR CT 06074-0791 860-644-0113

1447232046 NOROIAN GARY 123 SUMMER STREET SUITE 380N WORCESTER MA 01608-1216 508-368-5424

1205212800 NORTON COURTNEY 43 WOODLAND STREET, SUITE G-80 GOTHIC PARK HARTFORD CT 06105-2363 860-533-3091

1174750806 NORVAL CHRISTOPHER 645 FARMINGTON AVENUE HARTFORD CT 06105-2946 860-570-3400

1033472568 NOTIK SHIMRAT 999 SUMMER ST STE 305 STAMFORD CT 06905-5513 203-428-4440

1750307948 NOVELLA MICHELE 7 OLD SHERMAN TURNPIKE SUITE 102 DANBURY CT 06810-4174 203-947-5529

1780797860 NOYESDUGUAY LISA 85 BEACH STREET WESTERLY RI 02891-0717 401-596-8311

1013236330 NUNEZ ARISMENDY 2215 BURDETT AVE TROY NY 12180-2466 800-645-3055

1003888678 NUNEZ RAMON 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1750546925 NURGE NANCY 8 RONDALY RD AMSTON CT 06231-1744 860-424-6629

1477692093 NURZIA MICHAEL 166 WEST BROAD STREET SUITE 404 STAMFORD CT 06902-9317 203-356-9391

1619910155 O BRIEN KELLYANN 3400 MAIN STREET SPRINGFIELD MA 01107-1113 413-794-9560

1437433661 O'BRIEN TRAVIS 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7089

1518288612 O'DONNELL PATRICK #1 HEALTHCARE DRIVE PHILLIPI WV 26416-1051 623-582-2141

1790909737 O'HARA NANCY 3 HOLLYHOCK RD WILTON CT 06897-4443 203-834-2813

1861434607 O'NEILL DARREN 701 ENFIELD STREET ENFIELD CT 06082-2961 860-741-6572

1356671887 O'REILLY COLIN 200 SOMERSET ST NEW BRUNSWICK NJ 08901-1942 908-301-5402

1154438612 OBERKIRCH ANN 1 BRADLEY ROAD SUITE 106 WOODBRIDGE CT 06525-2235 203-389-3338

1932140035 OBERMAN ERIC CHILDREN'S & WOMAN'S PHYSICIAN 422 WESTERN HWY TAPPAN NY 10983-1311 914-922-2241

1598745978 OBORNE KAMMILLE 48 SANDERSON STREET GREENFIELD MA 01301-2778 413-773-2851

1770566689 OBRIEN MARTHA 300 SUMMIT ST HEALTH CENTER HARTFORD CT 06106-3100 860-297-2018

1447225941 OCONNELL KEVIN 455 TOLL GATE ROAD WARWICK RI 02886-2759 401-273-0641

HUSKY Health Connecticut Page 44 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 45: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1861476947 OCONNOR KEVIN 300 1ST AVE CHARLESTOWN MA 02129-3109 617-952-5000

1982629655 OESTREICHER MARK 160 HAWLEY LANE SUITE 104 TRUMBULL CT 06611-5379 203-377-0639

1609217058 OGIELA TEEGAN 52 BEACH ROAD FAIRFIELD CT 06824-5663 203-254-2000

1134255771 OGLAND OLAF 19 HALLS RD, SUITE 235 OLD LYME CT 06371-0046 860-434-9400

1083689020 OGRADY JOHN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1306834882 OGRADY LISA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1215986054 OHARGAN JOHN 5151 N. 9TH AVENUE PENSACOLA FL 32504-8721 850-416-6961

1265574560 OKEEFE LAUREN 30 SHELBURNE RD STAMFORD CT 06902-2638 203-276-7058

1922276708 OKONIEWSKI ANASTASIA 134 STATE STREET MERIDEN CT 06450-3293 203-237-2229

1285997403 OKS TATYANA 97 ELM STREET OLD SAYBROOK CT 06475-4144 860-388-4439

1225126832 OLEARY CAROL ANNE 175 NORTH BEACON STREET PERKINS SCHOOL FOR THE BLIND WATERTOWN MA 02472-2748 617-972-7290

1588776173 OLIN CRAIG 5 HIGH RIDGE PARK SUITE 103 STAMFORD CT 06905-1326 203-276-6151

1134267826 OLSEN LINDA 600 NORTHERN BLVD ALBANY NY 12204-1004 518-471-3266

1457476210 OLUWA TOPE 279 LINCOLN STREET WORCESTER MA 01605-2120 508-334-6556

1245221464 OMALLEY KIMBERLI 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1235541376 OMBREMBOWSKI RICHARD 6 GREENWICH OFFICE PARK 40 VALLEY DRIVE GREENWICH CT 06831-5151 203-869-1145

1629389994 ONDRUS REBECCA 455 TOLL GATE RD WARWICK RI 02886-9252 401-273-0641

1912929951 ONG ELIZABETH 555 WILLARD AVE NEWINGTON CT 06111-2631 860-666-6951

1467406140 OOMMEN MATHEW 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1275534281 ORBAN ZSOLT 111 BREWSTER STREET PAWTUCKET RI 02860-4474 401-921-7566

1568541761 OREN BRAD 1201 WEST MAIN STREET WATERBURY CT 06708-3105 203-573-4803

1356329155 ORGAN SCOTT 641-B CLARK AVENUE BRISTOL CT 06010-4068 860-582-6603

1558350637 ORTIZ HECTOR 1600 S ANDREWS AVE FORT LAUDERDALE FL 33316-2510 800-633-2243

1730150517 ORTIZ SANDRA CHILDREN'S & WOMAN'S PHYSICI 446 ROUTE 304-STE E BARDONIA NY 10954-1617 914-922-2241

1477749968 ORTIZ ORTIZ CARLOS 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1710184833 OSBAND YARDAENA CHILDREN'S & WOMAN'S PHYSICI 4350 VAN CORTLANDT PARK EAST BRONX NY 10470-1875 914-922-2241

1023201829 OSBORNE AARON 2600 BRUCE B DOWNS BLVD WESLEY CHAPEL FL 33544-9207 800-645-3055

1699928192 OSBORNE NICHOLAS 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1811985633 OSTREM MARK 54 MILLER STREET QUINCY MA 02169-4725 617-481-3300

1073556841 OSTROVSKAYA ANNA 1440 WHALLEY AVE NEW HAVEN CT 06515-1144 203-389-5599

1346659778 OTREBA CATHY 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-224-5438

1467611889 OTTEN MARC 685 WHITE PALINS ROAD EASTCHESTER NY 10709-5741 212-305-9705

1225085533 OVERMAN LILLIAN 144 MAIN ST. EAST HARTFORD CT 06118-3239 860-918-0069

1073689238 OWENS JEFFREY 1563 POST ROAD EAST WESTPORT CT 06880-5602 203-319-3939

1194893172 OWNBEY RICHARD CONNECTICUT VALLEY HOSPITAL BOX 351 - 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1780629261 PABALAN RAMON 636 DEL PRADO BLVD CAPE CORAL FL 33990-2695 800-645-3055

1043435134 PACHOLSKI VANESSA 970 FARMINGTON AVENUE SUITE 201 WEST HARTFORD CT 06107-2139 860-561-4300

1891812004 PACINI JANELLE 20 YORK STREET, CB-2041 NEW HAVEN CT 06510-3220 203-688-1734

1699708032 PADALIA SAMIR 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1386623957 PADILLA ALFRED 4 DEARFIELD DRIVE SUITE 102 GREENWICH CT 06831-5351 203-622-9160

1831187228 PAGE ERNEST 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1487816690 PAGLIA CAMILLE 3401 N BROAD ST PHILADELPHIA PA 19140-5103 215-707-1429

1548587892 PAIGE JOHN 2215 BURDETT AVE TROY NY 12180-2466 518-271-3450

1396709838 PAIS SHIREEN 19 BRADHURST AVE STE 206 HAWTHORNE NY 10532-2140 914-922-2241

1912010158 PALHETE ANA 2660 MAIN ST. SUITE 205 BRIDGEPORT CT 06606-5369 203-334-2000

HUSKY Health Connecticut Page 45 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 46: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1124041538 PALINSKI SUZANNE 1011 VETERANS MEMORIAL PARKWAY EAST PROVIDENCE RI 02915-5061 401-444-6779

1295773026 PALLANT ADAM 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-8531

1174520316 PALLANT BENNETT CHILDREN'S & WOMAN'S PHYSICIAN 906 ROUTE 6 MAHOPAC NY 10541-1704 914-922-2241

1093841850 PALLI MARIABEATRICE 50 STANIFORD ST 2ND FLOOR S50-200 BOSTON MA 02114-2517 617-726-2914

1528164241 PALMER BRET 1600 S ANDREWS AVE FT LAUDERDALE FL 33316-2510 954-847-4572

1700815032 PALMER LANE 1999 MARCUS AVE STE M18 NEW HYDE PARK NY 11042-1023 914-962-8290

1518971100 PALMER MARY 455 TOLLGATE ROAD WARWICK RI 02886-2759 401-273-0641

1063402493 PALOMBA JOSEPH 60 HOSPITAL RD LEOMINSTER MA 01453-2205 978-466-2580

1487625380 PALOMBA MARIA LIA 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1396077350 PANARELLA ANNE CHILDREN'S & WOMENS PHYSICIAN 19 BRADHURST AVE., SUITE 1400 HAWTHORNE NY 10532-2144 914-493-7997

1245228733 PANDYA KETAN 601 E. ROLLINS STREET ORLANDO FL 32886-3277 800-645-3055

1255575122 PANDYA SAMIR CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 1400 HAWTHORNE NY 10532-2140 914-922-2241

1285699488 PANKE RANDY 1 ROYCE CIRCLE SUITE 104 STORRS CT 06268-1000 860-487-9200

1518914944 PANNELLA LEA MACDOUGALL WALKER CORRECTIONAL 1153 EAST STREET SOUTH SUFFIELD CT 06080-0002 860-627-2100

1265488738 PANNILL FITZHUGH 201 OLD WATERBURY ROAD 2ND FLOOR STE 201 SOUTHBURY CT 06488-3848 203-646-6503

1306916846 PANTALEO ANTONIO 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1619210267 PANTER TRACIE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1053392019 PAPA DEBRA 119 BELMONT ST UMASS MEMORIAL MEDICAL CENTER WORCESTER MA 01605-2903 508-334-6255

1467620500 PAPOLOS DEMITRI 22 CRESCENT RD WESTPORT CT 06880-4509 203-226-2216

1376547992 PAPPAS ESTELL 330 ORCHARD STREET, 2ND FLR NORTHEAST MEDICAL GROUP, INC. NEW HAVEN CT 06511-4417 203-789-3152

1194982728 PARIDA SUPRIT 1000 SILVER STREET - BOX 351 MIDDLETOWN CT 06457-7023 860-262-5000

1801205752 PARIKH KRUTI ONE GENERAL STREET LAWRENCE MA 01841-2961 978-683-4000

1063621357 PARIKH NEETI 1250 SUMMER ST STAMFORD CT 06905-5358 203-853-9900

1144271552 PARIS SARAH 600 NORTHERN BLVD ALBANY NY 12204-1004 800-645-3055

1952440943 PARKE SUSAN 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1164826731 PARKER JODI 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1225075955 PARKER JOHN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1407817323 PARKER MICHELLE 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1326076795 PARKER PRIOR 200 SANDY HOLLOW ROAD MYSTIC CT 06355-1720 860-536-4916

1841651718 PARSLOW NATALIE 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-441-6767

1639111008 PARSONS JULIAN 61 SOUTH MAIN STREET SUITE 202 WEST HARTFORD CT 06107-2403 860-521-1264

1699777441 PARTON LANCE CHILDREN'S & WOMAN'S PHYSICIAN 100 WOODS RD VALHALLA NY 10595-1530 914-922-2241

1528050820 PARVEZ BORIANA CHILDREN'S & WOMAN'S PHYSICI 100 WOODS RD VALHALLA NY 10595-1530 914-922-2241

1760792626 PASKIND LAURA 55 FRUIT ST BOSTON MA 02114-2696 617-724-4100

1477606655 PASSARETTI DAVID 722 POST ROAD DARIEN CT 06820-4731 203-656-9999

1932189511 PATEL AJAY 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1679721617 PATEL ANUJ DANA FARBER CANCER INSTITUTE 450 BROOKLINE AVENUE LW-204 BOSTON MA 02215-5418 617-632-5917

1710935481 PATEL BHAVESH 1625 STRAITS TURNPIKE SUIT 205 MIDDLEBURY CT 06762-1836 203-598-7246

1659356566 PATEL BRIAN 211 PARK STREET ATTLEBORO MA 02703-0963 508-236-7040

1588755011 PATEL DANIEL 780 MAIN ST., STE.1 GREAT BARRINGTON MA 01230-2180 413-528-2418

1033409073 PATEL MINESH 1177 HIGH RIDGE RD STAMFORD CT 06905-1221 203-703-2555

1083934368 PATEL MRUGESHK 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1023218872 PATEL PAYAL CHILDREN''S & WOMENS PHYSICIAN 755 NORTH BROADWAY SLEEPY HOLLOW NY 10591-1076 914-366-3400

HUSKY Health Connecticut Page 46 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 47: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1285861443 PATEL RAJEN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1679732101 PATEL SHAHIL 1000 SILVER STREET MIDDLETOWN CT 06457-7203 860-262-5000

1306925284 PATRASCU MARIA WCMHN TORRINGTON 249 WINSTED RD TORRINGTON CT 06790-2958 203-805-6414

1548262660 PATRICK GEORGE 550 GOSHEN ROAD P0 BOX 161 LITCHFIELD CT 06759-0161 860-567-8350

1700889094 PATRIGNELLI ROBERT 17 CHURCH HILL ROAD TRUMBULL CT 06611-3116 203-261-0800

1336355114 PATTERSON BRUCE 177 BOSTON POST ROAD BOX 254 WATERFORD CT 06385-2803 860-447-2235

1437597614 PAUDEL UMESH CHILDREN''S & WOMENS PHYSICIAN 100 WOODS RAOD VALHALLA NY 10595-1530 914-922-2241

1407847056 PAUL ELAHNA 55 FRUIT ST YAWKEY 6 BOSTON MA 02114-2696 617-726-2908

1356670061 PAUL LISA CHILDREN'S & WOMAN'S PHYSICIAN 19 BRADHURST AVE. STE 1400 HAWTHORNE NY 10532-2140 914-922-2241

1245340348 PAYETTE CHRISTOPHER 263 POMFRET ST PUTNAM CT 06260-1835 860-928-3667

1992942205 PEABODY SHERI 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0797

1912932385 PEARL ADAM 15 CORPORATE DRIVE TRUMBULL CT 06611-1351 203-452-7081

1629206206 PECK CHRISTY 149 N ST WATERVILLE ME 04901-4995 800-645-3055

1992781207 PEFF PETER 100 PARK STREET GLENS FALLS NY 12801-4413 518-926-5109

1801107172 PELKEY BLUM JESSICA 29 LEWIS STREET GREAT BARRINGTON MA 01230-1713 413-881-5427

1114060506 PELLEGRINO MICHAEL 363 HIGHLAND AVE FALL RIVER MA 02720-3703 508-973-3584

1912923111 PELLINO PATRICIA 62 CARTER ROAD KENT CT 06757-0607 860-927-3772

1568805125 PELUSO FRANCESCO 300 GEORGE STREET SUITE 901 NEW HAVEN CT 06511-6662 203-785-2095

1043208531 PELUSO VANESSA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1992746994 PENICK CHARLES 1001 SAM PERRY BLVD FREDERICKSBURG VA 22401-4453 800-645-3055

1700874955 PENNEY KEITH 538 LITCHFIELD ST. G-01 CTR FOR ADV ORTHO & SPORTS CAR TORRINGTON CT 06790-6669 860-496-9877

1982665725 PENNOYER JENNIFER 701 COTTAGE GROVE RD. E110 BLOOMFIELD CT 06002-3080 860-882-6168

1730195751 PERERA TARIQUE 84 HOSPITAL AVENUE DANBURY CT 06810-6047 203-792-0400

1922149608 PEREZ MICHELLE 435 LEWIS AVE MERIDEN CT 06451-2101 330-493-4443

1225181274 PERGIOVANNI EDWARD 825 F CROMWELL AVENUE ROCKY HILL CT 06067-3013 860-721-9002

1700229168 PERGIOVANNI MARY 825 CROMWELL AVE SUITE F ROCKY HILL CT 06067-3007 860-721-9002

1619288057 PERLI DANIEL 123 SUMMER ST WORCESTER MA 01608-1216 401-273-0641

1699843888 PERRETZ PERRY 112 PORTLAND AVE REDDING CT 06896-3119 203-544-9090

1548593163 PERRIER DIAZ NAMYSHAYE 64 ROBBINS STREET WATERBURY CT 06708-2613 919-425-1533

1548378813 PESCE JOSEPH 4699 MAINST SUITE 212 BRIDGEPORT CT 06606-1830 203-372-8949

1770691552 PESCE KATHERINE 4699 MAIN STREET, SUITE 212 BRIDGEPORT CT 06606-1830 203-372-8949

1598951741 PESHORI SANGEETA 915 RIVER ROAD MIDDLETOWN CT 06457-2797 860-704-4000

1295881274 PETERSON MARK 1200 N BEAVER ST FLAGSTAFF AZ 86001-3118 800-645-3055

1508959099 PETERSON PETER 291 FARMINGTON AVE FARMINGTON CT 06032-1925 860-677-8747

1023375706 PETERSON RYAN 20 YORK STREET YNHH TOMPKINS 2 RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1205850377 PETHICK MARK 532 CHAPEL STREET NEW HAVEN CT 06511-6905 203-865-4286

1477580843 PETRONE WILLIAM 29 LEWIS AVENUE GREAT BARRINGTON MA 01230-1713 413-447-2752

1790874683 PEYSER MARC 778 LONG RIDGE ROAD SUITE 102 STAMFORD CT 06902-1251 203-329-7122

1962647743 PEZZINO PAUL 360 MAIN STREET SUITE 3 HARTFORD CT 06106-1880 860-681-8169

1932416740 PHADKE MADHURA YALE UNIV SOM, 333 CEDAR ST LMP 4093; BOX 208064 NEW HAVEN CT 06520-3206 203-785-4649

1881795508 PHAM DEANNA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1972615425 PHAM KIMTHU 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2770 201-932-5711

1659614337 PHILLIP TAMMI MARIE 20 YORK STREET YNHH NEW HAVEN CT 06510-3220 203-688-9503

1972957587 PHILLIPS ANNMARIE 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-384-8943

HUSKY Health Connecticut Page 47 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 48: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1952423188 PHILLIPS JAMES 300 BROOKLINE AVE BOSTON MA 02215-5400 617-754-9051

1316074446 PHILLIPS JULIE 3000 CORAL HILLS DRIVE CORAL SPRINGS FL 33065-4108 800-633-2243

1700186228 PHILLIPS KATHRYN 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0797

1306876255 PHILLIPS STEVEN 944 DANBURY ROAD WILTON CT 06897-4909 203-544-0005

1003106360 PIASECKA JUSTYNA YALE CHILD STUDY CENTER 730 SOUTH FRONTAGE ROAD NEW HAVEN CT 06519-1124 203-737-7129

1295072866 PICKRELL AARON 615 S. NEW BALLAS ROAD SAINT LOUIS MO 63141-8221 314-364-3829

1962632125 PIERRO ANTHONY 7171 NORTH DALE MABRY HWY TAMPA FL 33614-2665 800-645-3055

1043261266 PIMENTEL MARTHA CHILDREN'S & WOMAN'S PHYSICIAN 906 ROUTE 6 MAHOPAC NY 10541-1704 914-922-2241

1740268622 PINKES VICTOR 111 BREWSTER STREET PAWTUCKET RI 02860-4474 401-273-0641

1043212350 PINTO FRANK 761 MAIN AVE SUITE 201 NORWALK CT 06851-0001 860-282-4133

1205814233 PISSERI TERRI 1073 NORTH BENSON ROAD FAIRFIELD CT 06824-5171 203-254-4011

1982706032 PITEGOFF JOHN 1225 SILVER STREET MIDDLETOWN CT 06457-3920 860-638-2620

1821298977 PLANT LARRY 189 STORRS RD MANSFIELD CENTER CT 06250-1683 860-465-5904

1407898240 PLEET DAVID 2150 MAIN STREET SPRINGFIELD MA 01104-3300 860-741-6572

1760402390 PLEIMANN JENNIFER 2876 MAIN STREET STRATFORD CT 06614-4984 203-696-6125

1225345739 PLONSKY-SHEEDY JENNIFER 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0797

1295889681 PLYMOUTH CARINE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1912358375 POINDEXTER DOMANICE 999 SUMMER STREET SUITE 304 STAMFORD CT 06905-5513 203-325-5700

1831231323 POLIMENI ANGEL 220 WESTCHESTER AVE PORT CHESTER NY 10573-4516 914-939-6696

1437399904 POLLACK BRIAN 17 CEDAR STREET NEW BRITAIN CT 06052-1301 860-832-8625

1710966924 POLSON KATHLEEN DANA FARBER CANCER INSTITUTE 450 BROOKLINE AVENUE BOSTON MA 02215-5418 617-632-5917

1801817705 POMERANIEC LAZARO ONE POST ROAD FAIRFIELD CT 06824-6241 203-255-7617

1902857915 PONCE ANIBAL 725 NORTH STREET PITTSFIELD MA 01201-4124 413-477-2752

1114192242 PONCE DORIS 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1356702831 PONTE AMANDA 11 SOUTH ROAD STE. 150 FARMINGTON CT 06032-2484 860-674-0222

1538509492 POOLE RICHARD 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1700045895 POOLEY RICHARD 32 COOPER HILL ROAD RIDGEFIELD CT 06877-5904 203-431-3200

1144473927 POPE JENNIFER 101 PAGE STREET NEW BEDFORD MA 02740-3464 508-973-3584

1013294826 POPIUK NATALIA 25 OAKLAND ROAD STE. 1 SOUTH WINDSOR CT 06074-2897 860-644-5684

1467851923 POPKE MAUREEN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1326299926 PORTER JASON 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1902871270 PORTER NANCY 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1366478315 POSSICK STANLEY 303 WHITNEY AVENUE NEW HAVEN CT 06511-7204 203-782-1511

1598887218 POTENZA MARC 205 ORANGE STREET NEW HAVEN CT 06510-2069 203-776-9900

1427149798 POTLER ANDREW 780 MAIN ST., STE.1 GREAT BARRINGTON MA 01230-2180 413-528-2418

1609841097 POTTER MELISSA 67 BELMONT STREET WORCESTER MA 01605-2903 508-334-8152

1194135335 POTTINGER BARBARA NATCHAUG HOSPITAL 189 STORRS RD MANSFIELD CENTER CT 06250-1683 860-456-1311

1568754786 POUDEL DILLI 500 UPPER CHESAPEAKE DR BEL AIR MD 21014-4324 623-582-2141

1073949509 POUPON MARY 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1013000918 POURESMAIL MEHRAN 19 CENTERVIEW RD WOODBRIDGE CT 06525-1842 203-298-0724

1770840894 POWERS ALBERT 20 YORK STREET - YNHH 300 GEORGE ST. DPT PSYCHIATRY NEW HAVEN CT 06510-3220 203-785-2095

1558378257 POWERS ROBIN 701 ENFIELD STREET ENFIELD CT 06082-2961 860-741-6572

1760497564 PRALEA ANCA CONNECTICUT VALLEY HOSPITAL BOX 351 - 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1225126014 PRALEA CATALIN 401 WEST THAMES STREET BLDG 301 NORWICH CT 06360-7167 860-859-4674

1508995044 PRASHAD PRIYA CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 1400 HAWTHORNE NY 10532-2140 914-922-2241

HUSKY Health Connecticut Page 48 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 49: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1013962869 PRATOR PAUL 7171 N. DALE MABRY HWY. TAMPA FL 33614-2665 800-645-3055

1285877894 PRESLEY CAROLYN 333 CEDAR ST NEW HAVEN CT 06510-3206 475-202-9737

1407940521 PRESSON YUNIKA 593 EDDY STREET PROVIDENCE RI 02903-4923 401-793-9132

1093789745 PREYSNER LINDA 40 DALE ROAD SUITE 202 AVON CT 06001-3692 860-678-7897

1124252507 PRIBIS MARIA 1351 WASHINGTON BLVD SUITE 101 STAMFORD CT 06902-2419 203-327-5808

1982842100 PRICE LEIGH 455 TOLL GATE ROAD WARWICK RI 02886-2759 401-273-0641

1104891407 PRICE RICHARD 441 ROUTE 306 ST 3 MONSEY NY 10952-1234 845-893-4538

1215931688 PRIESTON GREGORY 5 EVERSLEY AVENUE NORWALK CT 06851-5821 203-853-6626

1952595902 PRITZ MELINDA 83 BRADLEY STREET NORTH HAVEN CT 06473-9996 203-234-1340

1124034228 PROSSEDA ERIC 1 RIVER STREET THUNDERMIST HEALTH CENTER WAKEFIELD RI 02879-3214 401-767-4100

1235577792 PROZORA STEPHANIE 20 YORK STREET YNHH PEDIATRIC HEM/ONC NEW HAVEN CT 06510-3220 203-688-4242

1912966862 PRUZAN CRISTINA 600 NORTHERN BLVD ALBANY NY 12204-1004 623-241-8350

1679575112 PRUZAN DEBRA 1290 SUMMER STREET SUITE 3600 STAMFORD CT 06905-5325 203-325-3576

1144774597 PRZYBYSZEWSKI KATHRYN 759 CHESTNUT STREET SPRINGFIELD MA 01107-1619 413-794-3233

1376539213 PUGLISI JEFFREY 7 RIVERSVILLE ROAD GREENWICH CT 06831-3684 203-531-1808

1902835176 PUNJANI SHAHNAZ 20 YORK STREET FITKIN CARDIOLOGY NEW HAVEN CT 06510-3202 203-785-6484

1942412655 PURVIS WARREN 29 ELBOW STREET PROVIDENCE RI 02903-4620 401-421-8850

1194899286 PUTNAM ADAM 528 WASHINGTON HIGHWAY MORRISVILLE VT 05661-8973 508-482-9600

1922108422 QUALLS RANDAL 1333 S. SAM HOUSTON BLVD. HOUSTON MO 65483-2046 623-241-8321

1699744425 QUAS MICHAEL 455 TOLL GATE RD WARWICK RI 02886-2759 401-737-7000

1558519678 QUATINETZ LARA 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1609928704 QUATROCELLI STEPHEN 360 TOLLAND TPKE., SUITE 2A MANCHESTER CT 06042-1770 860-646-4811

1245281567 QUINN BRIAN 725 NORTH STREET PITTSFIELD MA 01201-4019 413-881-5427

1831539154 RABH SHIHAB 1447 N. HARRISON SAGINAW MI 48602-4727 800-645-3055

1558439836 RACHELLI DEREK 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1902803265 RACHFAL STEPHAN 736 IRVING AVENUE SYRACUSE NY 13210-1690 800-645-3055

1558522482 RADAKOVICH RYAN 1700 SOUTH TAMIAMI TRAIL SARASOTA FL 34239-3509 800-645-3055

1265742860 RADHAKRISHNAN RAJIV 300 GEORGE STREET SUITE 901 NEW HAVEN CT 06511-6624 203-785-2089

1023480829 RADI NICOLE 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0791

1417045402 RAFII FEREIDOON 12 WEST 96TH STREET SUITE 1B NEW YORK NY 10025-9998 212-666-2445

1558360636 RAFTERY CHARLES 1579 STRAITS TURNPIKE MIDDLEBURY CT 06762-1835 203-758-2003

1962518688 RAGGIO CATHLEEN 535 E. 70TH ST NEW YORK NY 10021-4823 646-797-8471

1598044133 RAJANNA CHAMPAKAMALA 189 STORRS ROAD MANSFIELD CENTER CT 06250-1683 860-465-5906

1205917655 RAKOS LYNN 1635 CENTRAL AVE BRIDGEPORT CT 06610-2717 203-551-7464

1417024084 RALLO JOHN 1081 HOPE ST STAMFORD CT 06907-1824 203-461-4719

1932357712 RAMIREZ DILAN 29 LEWIS STREET GREAT BARRINGTON MA 01230-1713 413-881-5427

1124281332 RAMIREZ RICHMOND 186 PROVIDENCE STREET THUNDERMIST HEALTH CENTER WEST WARWICK RI 02893-2508 401-767-4100

1306873468 RANA ALPANA 555 WILLARD AVE VA MEDICAL CENTER NEWINGTON CT 06111-2631 860-666-6951

1053407304 RANA SUNIL 49 LAKE AVE, STE 2 GREENWICH CT 06830-4501 203-869-7704

1114196367 RANGANATHAN MOHINI 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016

1023130101 RAO MAYA 622 WEST 168TH STREET PH-4 ROOM 476 NEW YORK NY 10032-3270 212-305-5020

1902840556 RAPPAI JAMES 65 JAMES STREET EDISON NJ 08820-3947 800-432-4334

1689763989 RASHKOFF EVAN 50 AMENIA ROAD SHARON CT 06069-2268 860-355-8000

1265415152 RATHER MANZOOR 1500 LANSDOWNE AVE DARBY PA 19023-1291 623-582-2141

1063625747 RATHMAN DMD LLC PETER 125 STRAWBERRY HILL AVENUE SUITE 204 STAMFORD CT 06902-2536 203-327-1470

HUSKY Health Connecticut Page 49 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 50: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1295768141 RATTNER ROBERT 1101 NOTT ST SCHENECTADY NY 12308-2425 801-256-1900

1528006038 RAU GREGORY 134 PARK STREET NEW HAVEN CT 06511-5409 203-865-6143

1992962708 RAUB JONATHAN 189 STORRS ROAD MANSFIELD CENTER CT 06250-1683 860-465-5936

1255563938 RAUF MUHAMMAD 200 SOMERSET ST MILLINOCKET ME 04462-1258 800-645-3055

1427053701 RAVIN ANATOLIY 85 SEYMOUR STREET SUITE 922 SUITE 922 HARTFORD CT 06106-1118 860-790-0260

1629210281 RAVVEN SIMHA 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7300

1659527851 RAYMOND MARIE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1689027542 RAYTA NICOLE 1 RIVER ST WAKEFIELD RI 02879-3214 401-615-2800

1841418944 REAGAN JOHN 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-5435

1720251523 REAGAN KRISTA 85 SEYMOUR STREET SUITE 525 HARTFORD CT 06106-5525 860-545-4338

1558336669 REALI-MARINI DIANE 455 TOLLGATE ROAD WARWICK RI 02886-2759 401-273-0641

1750458949 RECTOR FRANKLIN CTR PATRICK F. MCAULIFFE CENTE 70 CENTRAL AVE WATERBURY CT 06702-1207 203-346-1931

1376579938 REDA EDWARD 150 WHITE PLAINS ROAD SUITE 306 TARRYTOWN NY 10591-5521 914-962-8290

1215960067 REDLER MICHAEL 888 WHITE PLAINS RD TRUMBULL CT 06611-4552 203-268-2882

1235428533 REEDDAY HEATHER 1924 ALCOA HWY KNOXVILLE TN 37920-1511 800-645-3055

1740222744 REEDER LAURIE 1351 SO COUNTY TRAIL SUITE 200B EAST GREENWICH RI 02818-2770 401-273-0641

1013989425 REGAN FORD SARA 593 EDDY STREET PROVIDENCE RI 02903-4923 401-793-8830

1457351645 REGARD MONIQUE CHILDREN''S & WOMAN''S PHYSICI 503 GRASSLANDS RD STE 200 VALHALLA NY 10595-1593 914-922-2241

1659649531 REGINA ANGELA 4422 3RD AVE BRONX NY 10457-2545 800-645-3055

1336586510 REID KEILIHA 1635 CENTRAL AVENUE BRIDGEPORT CT 06610-2717 203-551-7400

1073821187 REISCHERL ANDREA 986 NORWICH NEW LONDON TPKE UNCASVILLE CT 06382-1928 860-848-5773

1619047982 REISER RUTH 80 SEYMOUR ST HARTFORD CT 06102-5037 860-972-4178

1659474781 REISMAN ANNA 550 WILLARD AVE NEWINGTON CT 06111-2631 860-666-6915

1972847580 REISS MOSHE CHILDREN'S & WOMENS PHYSICIAN 19 BRADHURST AVE.SUITE 1400 HAWTHORNE NY 10532-2144 914-493-7997

1447304605 RENAUD THOMAS 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-5241

1184032898 RENNELL KRISTIN 3300 MAIN STREET 3RD FL, STE C&D SPRINGFIELD MA 01199-1619 413-794-7033

1205947306 RESOR STANLEY 159 WEST PUTNAM AVE GREENWICH CT 06830-5329 203-987-3117

1255510913 RESSLER ILANA 100 TECHNOLOGY DRIVE SUITE 210 TRUMBULL CT 06611-6303 203-880-5416

1467613554 RICCARDELLI WILLIAM 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1093808727 RICHARDSON ELBERT 234 CHURCH STREET SUITE 301 NEW HAVEN CT 06510-1804 203-215-7472

1477666881 RICHARDSON SHOSHONE 3000 32ND AVE SW FARGO ND 58103-6132 701-364-8000

1417081928 RIEBELING CURT 21 SUGAR STREET NEWTOWN CT 06470-2045 203-426-7122

1871535500 RIECKER WILLIAM 2261 BROADBRIDGE AVENUE STRATFORD CT 06614-3860 203-375-4633

1033194105 RIEDEL JOHN 111 BREWSTER STREET PAWTUCKET RI 02860-4499 401-273-0641

1225124514 RIEGLER NITAI 1 GOLDEN HILL ST MILFORD CT 06460-4630 203-876-6848

1649408725 RIESE JEFFREY 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-7396

1487683173 RISHWORTH CHRISTIE 600 MOUNT PLEASANT AVE PROVIDENCE RI 02908-1991 401-456-8055

1861643827 RIST ELIZABETH 2 MEDICAL CENTER DRIVE SUITE 309 SPRINGFIELD MA 01107-1270 413-794-5363

1144531781 RITTER SETH 250 PLEASANT STREET EMERGENCY DEDP CONCORD NH 03301-7539 951-430-1497

1043347537 RIVAS JAIME 220 WESTCHESTER AVE PORT CHESTER NY 10573-4558 914-939-6696

1386826527 RIVERA HECTOR 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1699731661 RIVERA JOHN 1753 MERIDEN-WATERBURY RD POBOX 770 MILLDALE CT 06467-0770 860-621-5554

1225039233 RIVERA FERRER FRANCISCO 84 N. MAIN STREET BLDG 2 BRANFORD CT 06405-3061 203-626-0160

1720044811 RIVERA JR. JOHN 1753 MERIDEN-WATERBURY RD POBOX 770 MILLDALE CT 06467-0770 860-621-5554

1255543609 RIX ROBERT 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

HUSKY Health Connecticut Page 50 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 51: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1194818013 RIXON JOHN 55 WEBSTER HILL BLVD WEST HARTFORD CT 06107-3458 860-561-7131

1851419014 RIZEN BRIAN WOODS SERVICES 515, ROUTE 413 LANGHORNE PA 19047-0036 267-565-8239

1114005089 RIZVI TAHIR 7050 GALL BLVD ZEPHYRHILLS FL 33541-1347 800-645-3055

1396030631 RIZVI WAQAR 20 YORK STREET YNHH DEPARTMENT OF PSYCHIATRY NEW HAVEN CT 06510-3220 203-688-9503

1457345605 RO HOWARD 701 ENFIELD STREET ENFIELD CT 06082-2961 860-741-6572

1497041149 ROBB VANESSA 51 MARKET SQUARE NEWINGTON CT 06111-1902 860-667-0818

1558474171 ROBBEN CHRISTOPHER 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1477665420 ROBBINS MICHAEL 1 LONG WHARF DR STE 212 NEW HAVEN CT 06511-5593 203-624-4208

1306853262 ROBERTS MATTHEW 535 E. 70TH ST NEW YORK NY 10021-4823 626-797-8471

1376633248 ROBISON KATINA 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1841449196 ROBSON LINDA 64 WASHINGTON STREET MYSTIC CT 06355-2811 860-536-7100

1912052705 ROBTOY SHERRI 1 LONG WHARF DR STE 212 NEW HAVEN CT 06511-5593 203-624-4208

1154345890 RODGERS ALAN 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1720198146 RODGERS JR JOSEPH 105 SOCKANOSSET CROSS ROAD SUITE 320 CRANSTON RI 02920-0320 401-946-7600

1326036765 RODRIGUEZ MARITZA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-345-6055

1497706519 RODRIGUEZ DE LEON OSCAR 725 NORTH STREET PITTSFIELD MA 01201-4124 413-447-2752

1013904770 RODRIGUEZ-CARDENAS JAIRO 81-36 BAXTER AVENUE #2F ELMHURST NY 11373-1382 718-507-1717

1447541271 ROGERS ERIC 100 PARK STREET GLENS FALLS NY 12801-4413 801-256-1900

1851512784 ROGERS GAIL 975 CORBIN AVE NEW BRITAIN CT 06052-1243 860-356-8224

1861465973 ROGERS HOWARD 111 SALEM TPKE STE 7 NORWICH CT 06360-7403 860-859-2262

1932113073 ROHR MICHELE 159 WEST PUTNAM AVENUE GREENWICH CT 06830-5329 203-869-7080

1801977830 ROMAN DOLORES 559 WEST GERMANTOWN PIKE EAST NORRITON PA 19403-4250 623-582-2141

1942582705 ROMAN RODRIGUEZ CHRISTIAN 111 BREWSTER STREET PAWTUCKET RI 02860-4474 401-921-7566

1407853153 ROMANIA ANTHONY 82 PLAZA COURT ROMANIA EYE CENTER, LLC GROTON CT 06340-0000 860-629-0900

1487646063 ROMANO ALICIA CHILDREN'S & WOMAN'S PHYSICI 755 N BROADWAY STE. 400 SLEEPY HOLLOW NY 10591-1076 914-922-2241

1235129412 ROMERO RICHARD 115 MILL ST BELMONT MA 02478-9106 617-855-2921

1164526349 ROOF III ROBERT 3421 W 9TH ST WATERLOO IA 50702-5401 800-633-2243

1093058356 ROQUE ASHLEY 20 YORK STREET YNHH TOMPKINS 226 NEW HAVEN CT 06510-3220 203-688-9503

1124197033 ROSA STEVEN 715 LAKEWOOD ROAD WATERBURY CT 06704-5400 203-573-0011

1932496882 ROSARIO JAVIER 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1679543680 ROSE ARON 40 TEMPLE STREET SUITE 5B NEW HAVEN CT 06510-2715 203-573-4885

1023118999 ROSENBERG ILENE 40 COMMERCE PARK SUITE 1 MILFORD CT 06460-3506 203-878-3531

1932204203 ROSENBERG REMI 5 HIGH RIDGE PARK SUITE 103 STAMFORD CT 06905-1326 203-276-6151

1669423042 ROSENBERG ROBERT CHILDREN'S & WOMAN'S PHYSICIAN 130 GRAND ST. CROTON ON HUDSON NY 10520-2307 914-922-2241

1730100546 ROSENKRANZ BARRY YALE BEHAVIORAL HEALTH 55 CHURCH ST.SUITE 403 NEW HAVEN CT 06510-3014 203-764-7276

1710935788 ROSENTHAL BARRY 259 FIRST STREET MINEOLA NY 11501-3957 516-663-2727

1831185719 ROSS DOUGLAS 15 PARKMAN ST WANG 730S BOSTON MA 02114-3117 617-726-3872

1629016407 ROSS IV ALBERT 593 EDDY STREET HASBRO LL PROVIDENCE RI 02903-4923 401-444-1767

1275976052 ROSSIGNOL JOHN 36 EAST MAIN STREET AVON CT 06001-3801 860-674-0333

1538272117 ROSTENBERG PETER 71 ROUTE 39 NEW FAIRFIELD CT 06812-4017 203-746-3300

1972570422 ROTONDO KATHLEEN 1 HOPPIN STREET CORO WEST PROVIDENCE RI 02903-4923 401-793-8830

1770591190 ROUSE DWIGHT 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1780782292 ROWE RACQUEL 700 POQUONOCK AVE WINDSOR CT 06095-2219 860-217-0764

1952316622 ROYE DAVID 1351 WASHINGTON BLVD STAMFORD CT 06902-9317 203-276-2000

HUSKY Health Connecticut Page 51 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 52: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1205865649 ROYE KRISTIN CHILDREN'S & WOMAN'S PHYSICIAN 755 N BROADWAY STE. 500 SLEEPY HOLLOW NY 10591-1075 914-922-2241

1245775717 ROZENTSVIT ARTUR 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1275599201 RUBEN GEOFFREY 155 WILSON AVENUE WASHINGTON PA 15301-3336 724-223-3060

1578593497 RUBEN HARVEY 77 KNOLLWOOD DRIVE NEW HAVEN CT 06515-9998 203-397-0064

1326070293 RUBENSTEIN BRIAN 3636 HIGH STREET PORTSMOUTH VA 23707-3236 804-627-5536

1770572232 RUBEO THOMAS CHILDREN'S & WOMAN'S PHYSICIAN 1 PONDFIELD RD STE. 302 BRONXVILLE NY 10708-3706 914-922-2241

1114297058 RUBINO ALFRED 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0797

1437161148 RUBINO KARA 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0797

1457388183 RUBINO LAUREEN 945 MAIN STREET SUITE 105 MANCHESTER CT 06040-6064 860-645-1232

1528067766 RUBINSTEIN STEVE 910 E BOSTON POST RD MAMARONECK NY 10543-4109 914-835-6990

1164673604 RUBY JR ROBERT 1000 BOSTON POST ROAD WEST HAVEN CT 06516-1726 203-933-8899

1497717680 RUCHMAN MARK 1 RESERVOIR OFFICE PARK #203 1449 OLD WATERBURY RD SOUTHBURY CT 06488-3853 203-264-4000

1023102910 RUCHO MARY 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1598927634 RUDICH DANIELLE 1201 W. MAIN ST SUITE 100 WATERBURY CT 06708-4926 203-573-4858

1508841388 RUSCH VALERIE 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1588772867 RUSER CHRISTOPHER 11-ACSL 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2700 866-808-7921

1467402693 RUSHIN RANDALL 20-30 BEAVER ROAD SUITE 102 WETHERSFIELD CT 06109-2242 860-721-7428

1295793586 RUSHING SARA 5151 N. 9TH AVENUE PENSACOLA FL 32504-8721 850-416-6961

1508971318 RUSK ALICE 25 VALLEY DRIVE GREENWICH CT 06831-5203 203-869-6446

1689672347 RUSSELL DONNA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1750494225 RUSSELL ROSEMARY 2443 ROUTE 6 BREWSTER NY 10509-2528 845-363-1644

1477548295 RUSSINOFF IAN 1600 S ANDREWS AVE FORT LAUDERDALE FL 33316-2510 954-847-4572

1982040390 RUSSO ARMAND 20 YORK STREET YNHH HEMATOLOGY ONCOLOGY NEW HAVEN CT 06510-3220 203-688-9503

1891762837 RUSSO MICHAEL 400 WEST MAIN STREET BRANFORD CT 06405-3416 203-483-7778

1548540370 RUSTOMJI KASHMIRA 20 YORK STREET YNHH CPIS NEW HAVEN CT 06510-3220 203-688-9503

1184708851 RYAN GAIL 105 MILLBURY ST AUBURN MA 01501-3205 508-832-9691

1477878049 RYAN SYLVESTER 639 BREAKNECK HILL ROAD MIDDLEBURY CT 06762-1410 203-758-9564

1316189442 RYVKIN INNA ONE GENERAL STREET LAWRENCE MA 01841-2961 978-689-6683

1003806183 SAAVEDRA ARTURO 50 STANIFORD ST 2ND FLOOR BOSTON MA 02114-2517 617-726-2914

1598861064 SAAVEDRA LUISA 216 WESTCHESTER AVE,SUITE12 PORT CHESTER NY 10573-4541 914-690-0333

1831291715 SABATELLI RAYMOND 29 LEWIS AVE GREAT BARRINGTON MA 01230-1713 413-447-2752

1821000613 SABERSKI LLOYD 1 LONG WHARF DR STE 212 NEW HAVEN CT 06511-5593 203-624-4208

1356357933 SABSHIN JAMES 12 VILLAGE STREET SUITE 3 NORTH HAVEN CT 06473-9997 203-877-0112

1477642833 SACKLER LORNA CHILDREN'S & WOMAN'S PHYSICI 4C MEDICAL PARK DRIVE POMONA NY 10970-3516 914-922-2241

1427308105 SADANOWICZ ALEXANDRA 163 BROADWAY STREET COLCHESTER CT 06415-1022 860-537-2020

1235209347 SAEED AYSHA 555 WILLARD AVENUE NEWINGTON CT 06111-2631 860-666-6951

1346318334 SAEEDI MEDHI 1000 SILVER STREET MIDDLETOWN CT 06457-7203 860-262-5000

1558306225 SALAHUDDIN KAZI 2180 MEDON ROAD SUITE 21 CUMBERLAND RI 02864-3842 401-333-3810

1386686772 SALANI VARSHA 10 BROADWAY NORTH HAVEN CT 06473-2301 203-234-1901

1306937065 SALDAITIS DANA 950 CAMPBELL AVENUE 11ACSL WEST HAVEN CT 06516-2770 203-932-5711

1093121642 SALISBURY KATHLEEN 455 TOLL GATE ROAD WARWICK RI 02886-2759 401-921-7566

1174505275 SALOMON NADIM 10 UNION SQUARE EAST SUITE 3F NEW YORK NY 10003-9575 212-420-4006

1508860859 SALZER STEPHEN 49 LAKE AVENUE SUITE 103 GREENWICH CT 06830-4501 203-869-2030

1720177165 SAMBOR RALPH 359 FARMINGTON AVE. PLAINVILLE CT 06062-1343 860-747-5761

1891797361 SAMPSON MARTHA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

HUSKY Health Connecticut Page 52 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 53: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1992779151 SANACORA GERARD 34 PARK ST. NEW HAVEN CT 06519-1109 203-974-7016

1467730416 SANAMANDRA SIRISHA 15 YORK ST LCI 910, NEUROLOGY RESIDENCY NEW HAVEN CT 06510-3221 203-785-6054

1356308464 SANCHEZ ANTONIO NATCHAUG HOSPITAL 189 STORRS RD MANSFIELD CENTER CT 06250-1683 860-456-1311

1285018085 SANDERSON ERIN 119 BELMONT STREET WORCESTER MA 01605-2903 508-334-8152

1801827662 SANDERSON SCOTT 67 SAND PIT ROAD SUITE 208 DANBURY CT 06810-4032 203-853-0003

1568425171 SANDLER JEFFREY 4699 MAIN STREET SUITE 106 BRIDGEPORT CT 06606-1830 203-374-8182

1407833106 SANDOVAL SYBIL 44 DALE ROAD AVON CT 06001-4320 860-674-8830

1811218076 SANFORD MICHELLE 56 FRANKLIN ST WATERBURY CT 06706-1253 203-709-6160

1245557289 SANFORD RACHEL 300 WESTCHESTER AVE MSK HARRISON WEST HARRISON NY 10604-6007 646-227-3742

1932477585 SANJURJO TOMAS 290 ROBERTS STREET 2ND FLOOR EAST HARTFORD CT 06108-3684 860-826-4763

1982760005 SANTACROCE MICHAEL 44 FAIR ST WALLINGFORD CT 06492-4214 203-269-4730

1013905454 SANTAMBROSIO MARC 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1912274481 SANTANA LENIEL 601 E ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1982031449 SANTANA SARAH 736 IRVING AVENUE SYRACUSE NY 13210-1690 800-645-3055

1003809385 SANTAROSA RICHARD 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1174684179 SANTIAGO YVONNE CHILDREN'S & WOMENS PHYSICIAN 400 MIDWAY PARK DRIVE MIDDLETOWN NY 10940-2656 845-343-0728

1649602491 SANTIBANEZ KARINA 800 CROSS RIVER RD KATONAH NY 10536-3549 914-763-8151

1154450526 SANTORELLA JOHN 20 NORTH MAIN STREET NORWALK CT 06854-2656 203-866-6658

1902932031 SAPHIRE LYNN 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 615-224-5438

1336450261 SARASIN MATTHEW 111 BREWSTER STREET PAWTUCKET RI 02860-4474 401-273-0641

1720480577 SARHADI MARISSA 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1760466536 SATCHELL JACQUELINE 950 CAMPBELL AVENUE VA MEDICAL CENTER, PRIMARY CAR WEST HAVEN CT 06516-2700 203-932-5711

1770611717 SATINOVER JEFFREY 84 HOSPITAL AVENUE DANBURY CT 06810-6047 203-792-0400

1598904112 SATLOFF SARA 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1447494612 SAUTER CRAIG 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1790710689 SAVARESE EDWARD 90 S BEDFORD RD MOUNT KISCO NY 10549-3412 914-242-5621

1366482846 SAVIN RONALD 134 PARK STREET NEW HAVEN CT 06511-5409 203-865-6143

1811082472 SAVINO DOUGLAS CHILDREN''S & WOMAN''S PHYSICI 1 PONDFIELD RD WEST STE 7 BRONXVILLE NY 10708-2694 914-922-2241

1164873600 SAWYER KARA 701 ENFIELD STREET ENFIELD CT 06082-2967 860-741-6572

1629448378 SAYLOR CHELSEA 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-8853

1871649426 SCARPELLI PETER 101 NORTH MAIN ST WINSTED CT 06098-1738 860-379-6807

1841458759 SCHAMBERG NEAL 500 WEST PUTNAM AVE SUITE 100 GREENWICH CT 06830-6086 203-863-2908

1518908052 SCHANZ MARYBETH 605 WEST AVE NORWALK CT 06850-4000 203-853-9900

1689942559 SCHEINBERG KATHLEEN 327 HIGH STREET MIDDLETOWN CT 06459-3232 860-757-3035

1801983978 SCHERR JENNIFER CHILDREN''S & WOMAN''S PHYSICI 19 BRADHURST AVE. STE 2400 HAWTHORNE NY 10532-2144 914-922-2241

1689663262 SCHIFFER TODD CHILDREN''S & WOMAN''S PHYSICI 1075 CENTRAL AVENUE STE 102 SCARSDALE NY 10583-3242 914-922-2241

1497809784 SCHLUSSEL RICHARD 1999 MARCUS AVE STE M18 NEW HYDE PARK NY 11042-1023 914-962-8290

1407238785 SCHNEIDER ELENA 3300 MAIN STREET 3RD FLOOR, STE A SPRINGFIELD MA 01199-1619 413-794-7031

1518100197 SCHNEIDER LAUREN 1351 WASHINGTON BLVD SUITE 101 STAMFORD CT 06902-2449 203-327-5808

1497843197 SCHNEIDER MARCIE GREENWICH ADOLESCENT MEDICINE 239 GLENVILLE ROAD GREENWICH CT 06831-4172 203-532-1919

1184798852 SCHNEIDER OWEN 52 BEACH RD FAIRFIELD CT 06824-6017 203-254-2000

1366601213 SCHNEIDER ROBERT 72 DALTON RD MILFORD CT 06460-6908 203-226-6655

1982776340 SCHOEN MARY 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1598772766 SCHRAGER ALAN 1600 HARRISON AVENUE G102 MAMARONECK NY 10543-3145 914-698-8106

HUSKY Health Connecticut Page 53 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 54: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1528065984 SCHREIBER JONATHAN 1 BARNARD LANE SUITE 102 BLOOMFIELD CT 06002-2482 860-243-1889

1912091760 SCHWARTZ AMY 950 CAMPBELL AVE 11ACSL WEST HAVEN CT 06516-2770 866-808-7921

1891844080 SCOTTO JAMISON 1080 DAY HILL ROAD WINDSOR CT 06095-1781 860-683-0243

1427142918 SCULLY JASON 69 SHERMAN STREET FAIRFIELD CT 06824-5899 203-255-1545

1912160813 SECREST JULIE 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1073619391 SEDIVA IVONA 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-4201

1316939150 SEE MARY CELAINE CHILDREN'S & WOMAN'S PHYSICI 755 N BROADWAY STE. 400 VALHALLA NY 10595-1593 914-922-2241

1013042829 SEELEY DAVID 736 IRVING AVENUE SYRACUSE NY 13210-1690 800-645-3055

1912972548 SEEWALD RANDY 30 MILESTONE ROAD DANBURY CT 06810-5114 203-456-8353

1508889197 SEIDNER JACOB 70 WASHINGTON AVE NORTH HAVEN CT 06473-1703 203-530-1419

1447416086 SEIGEL JAY 24 CHANNING ST NEW LONDON CT 06320-5735 203-303-7387

1629079694 SELIGMAN KAREN CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 1400 HAWTHORNE NV 10532-2140 914-922-2241

1497080022 SELINGA SHARON 5 MELROSE DRIVE FARMINGTON CT 06032-2215 860-677-1316

1508912759 SELKIN ALAN 500 WEST PUTNAM AVE SUITE 100 GREENWICH CT 06830-6086 203-863-2908

1225171697 SELVAGE JOAN WCMHN TORRINGTON 249 WINSTED RD TORRINGTON CT 06790-2958 203-805-6414

1326123456 SELWYN PETER 40 ALBERT STREET NEW HAVEN CT 06511-1542 203-640-0341

1750541876 SEMENOVSKI MICHAEL 405 HIGHLAND AVENUE, STE-4 WATERBURY CT 06708-3419 860-294-4362

1376564559 SENAY KIM 9 SPRING STREET CHESTER CT 06412-1338 860-526-3455

1780747840 SEPLOWITZ BRUCE 60 ALGER RD EAST HADDAM CT 06423-1212 860-873-1777

1982867578 SEQUEIRA SHWETHA ONE BOSTON MEDICAL CENTER PL BOSTON MA 02118-2908 617-414-6033

1417948316 SEQUIST LECIA 55 FRUIT ST YAW 7B BOSTON MA 02114-2696 617-724-4000

1750344800 SERGEL SHEILA 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1275836371 SETH ANKUR 877 JEFFERSON AVENUE MEMPHIS TN 38103-2897 800-645-3055

1629374863 SEVCIK RENNE CHILDREN'S & WOMENS PHYSICIAN 755 NORTH BROADWAY SLEEPY HOLLOW NY 10591-1075 914-366-0015

1093855744 SEWARD GREGORY 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1144293317 SHABY STEVEN 1425 BEDFORD STREET SUITE 1M STAMFORD CT 06905-5204 203-357-0204

1518202944 SHACKELFORD JENNIFER 55 FRUIT ST BOSTON MA 02114-2696 617-643-2443

1639276827 SHAH ARVIND 417 HIGHLAND AVE. SUITE 1 WATERBURY CT 06708-3454 203-755-9300

1952666364 SHAH MANASI 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1730121997 SHAH SHETAL CHILDREN'S & WOMAN'S PHYSICI 100 WOODS RD VALHALLA NY 10595-1530 914-922-2241

1154359297 SHAHID S. JAVED 67 SAND PIT ROAD SUITE 208 DANBURY CT 06810-4032 203-853-0003

1235159658 SHAKER ASHRAF 7600 RIVER RD NORTH BERGEN NJ 07047-6217 800-645-3055

1366497679 SHALON LINDA 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-7167

1154320232 SHAMES MD BRUCE 761 MAIN AVE SUITE 201 NORWALK CT 06851-0001 860-282-4133

1295805927 SHAMSI RAHIM 60 WESTWOOD AVENUE WATERBURY CT 06708-2460 203-753-6160

1134278500 SHANDER ELLYN 1933 LONG RIDGE ROAD STAMFORD CT 06903-3201 203-561-0414

1538312228 SHANEHSAZ PIAM 4900 HOUSTON ROAD FLORENCE KY 41042-4824 859-655-0197

1932447489 SHAPIRO JONATHON 455 TOLL GATE ROAD WARWICK RI 02886-2759 401-273-0641

1295843613 SHAPIRO ROBERT 1767 SUMMER STREET SUITE 01 STAMFORD CT 06905-5123 203-323-3400

1730220443 SHAPIRO ROBERTA 115 EAST 61ST ST, STE 10A NEW YORK NY 10065-8183 212-888-4635

1659787125 SHARMA ANJALI 80 SEYMOUR ST HARTFORD CT 06102-5037 860-679-4763

1568615060 SHARMA GIRISH CHILDREN'S & WOMENS PHYSICIAN 503 GRASSLANDS RD SUITE 201 VALHALLA NY 10595-1503 914-367-0000

1871646836 SHARNICK MAUREEN 375 BRIDGEPORT AVE SHELTON CT 06484-3844 203-925-8510

1851709109 SHAW EMILY 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1184796484 SHAW STEVEN 136 WEST MAIN STREET FIRST FLOOR NEW BRITAIN CT 06051-1315 860-826-4763

HUSKY Health Connecticut Page 54 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 55: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1710974530 SHEA JUDITH 7 RIVERSVILLE ROAD GREENWICH CT 06831-3684 203-531-1808

1407016520 SHEAR MICHAEL 60 HOSPITAL RD WACHUSETT EMERGENCY PHYSICIANS LEOMINSTER MA 01453-2205 978-466-2580

1174681126 SHEEHY MICHAEL 3269 STOCKTON HILL RD KINGMAN AZ 86409-3619 800-633-2243

1568540789 SHEINTOP DAVID 256 NORTH MAIN ST SOUTHINGTON CT 06489-2524 860-276-0225

1689097636 SHELTON TYLER 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1164485306 SHEN JIAN 5010 STHWY 30 SUITE 205 AMSTERDAM NY 12010-7532 518-773-4242

1083794812 SHENDER ANNA 66 GLENBROOK RD STAMFORD CT 06902-8402 203-961-8241

1003927856 SHEPARD DANA 3600 EAST MAIN ST WATERBURY CT 06705-3851 203-596-0406

1568773166 SHEPHERD RACHEL 101 DUDLEY STREET PROVIDENCE RI 02905-1417 401-273-0641

1831171297 SHERIDAN ROBERT 51 BLOSSOM ST SBI BOSTON MA 02114-2601 617-726-3575

1124018015 SHERLOCK REBECCA 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1639144090 SHERRILL CHERYL 281 LINCOLN STREET WORCESTER MA 01605-2138 508-334-8152

1578506622 SHETTY TEENA 535 EAST 70TH ST. NEW YORK NY 10021-4823 646-797-8471

1629168059 SHEVIN WILLIAM 50 APPLEWOOD DRIVE WOODSTOCK CT 06281-2304 860-928-4040

1710144415 SHIFREEN JULIE 645 FARMINGTON AVENUE HARTFORD CT 06105-2946 860-570-3400

1871663328 SHIFREEN STEVEN 645 FARMINGTON AVENUE HARTFORD CT 06105-8705 860-570-3400

1346231248 SHIH HELEN 55 FRUIT ST YAW 108 BOSTON MA 02114-2696 617-724-9627

1073562195 SHIMELMAN M 1 LONG WHARF DRIVE SUITE 212 NEW HAVEN CT 06511-5991 203-314-3891

1972604528 SHITIA HUSAM 430 HIGHLAND AVE CHESHIRE CT 06410-2565 203-271-3132

1184792640 SHKOLNIKOV TATYANA CHILDREN'S & WOMAN'S PHYSICIAN 11 FAIR STREET CARMEL NY 10512-1301 914-922-2241

1568452159 SHOLOMSKAS ALAN 2440 WHITNEY AVE HAMDEN CT 06518-3222 203-776-2077

1982871612 SHTILBANS ALEXANDER 535 EAST 70TH STREET NEW YORK NY 10021-4823 646-797-8471

1669668729 SIBBALD JESSICA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1144360629 SICA ROBBAN 370 BOSTON POST ROAD ORANGE CT 06477-3534 203-799-7733

1861546103 SICILIA GAIL 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1093773814 SICKLE CHRISTINE 1515 ALLEN STREET SUITE B SPRINGFIELD MA 01118-1803 413-782-7646

1962758698 SIDAROS RAFIK 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1124214234 SIDDIQUA LATIFA CHILDREN'S & WOMAN'S PHYSICIAN 701 N BROADWAY SLEEPY HOLLOW NY 10591-1020 914-922-2241

1316264286 SIDHU-BUONOCORE SUNITA 79 WAWECUS ST SUITE 101 NORWICH CT 06360-2160 860-886-2655

1477879971 SIEGEL BERNARD 61 OX BOW LANE WOODBRIDGE CT 06525-1525 203-387-6633

1992117584 SIEGER KEITH 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1528316544 SIENEL HEATHER UMMC DEPT OF ORTHOPEDICS 55 LAKE AVE NORTH WORCESTER MA 01655-2982 774-443-2216

1013914167 SIKAND VIJAY 7 VAUXHALL ST NEW LONDON CT 06320-5711 860-443-2896

1700088051 SIKET MATTHEW 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1477523496 SILBERT JONATHAN 1201 WEST MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4885

1790719177 SILLS ROBERT 30 LOCUST ST NORTHAMPTON MA 01060-2052 413-881-5427

1669528311 SILVA LEE TRACY 1275 SUMMER STREET SUITE 105 STAMFORD CT 06905-5315 203-325-2667

1760619142 SILVER WENDY CHILDREN''S & WOMAN''S PHYSICI 755 N BROADWAY STE. 540 SLEEPY HOLLOW NY 10591-1076 914-922-2241

1952309858 SILVERMAN NIRA 22 WESTFIELD AVENUE ANSONIA CT 06401-1158 203-735-6144

1295788768 SILVIO ELISSA VA CLINIC 7 GERMANTOWN RD DANBURY CT 06810-2044 203-798-8422

1235205444 SIMJEE MOHAMMED CAPITOL REGION MENTAL HEALTH C 500 VINE STREET HARTFORD CT 06112-1639 860-297-0909

1477989929 SIMMONS DANIELLE 186 PROVIDENCE STREET THUNDERMIST HEALTH CENTER WEST WARWICK RI 02893-2508 401-767-4100

1427141365 SIMMONS DEBBIE 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0797

1174774681 SIMMONS ERIN 1071 BLUE HILL AVE MILTON MA 02186-2395 617-333-2182

HUSKY Health Connecticut Page 55 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 56: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1235101429 SIMMS ROBERT 725 ALBANY STREET SHAPIRO 7, SUITE B BOSTON MA 02118-2526 617-414-2507

1316057409 SIMOES MEERA 1 RANDALL SQUARE SUITE 205 PROVIDENCE RI 02904-2773 401-331-7181

1063495570 SIMONDS GARY 1906 BELLEVIEW AVE ROANOKE VA 24014-1838 800-645-3055

1730193251 SIMPSON ALISON 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1689601080 SIMPSON HAROLD 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1114956661 SINGH AKHILESH 555 WILLARD AVE VA MEDICAL CENTER NEWINGTON CT 06111-2631 860-666-6951

1235485061 SINGH BIRINDER 24 HOSPITAL AVE DANBURY CT 06810-6099 203-739-8105

1386602175 SINGH KABUL 43-73 UNION STREET SUITE CA FLUSHING NY 11355-3191 718-460-9395

1912108937 SINGH NANDITA CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 200N HAWTHORNE NY 10532-2140 914-922-2241

1952618720 SINGLETON MARISA 189 STORRS ROAD MANSFIELD CENTER CT 06250-1683 860-456-1311

1609895366 SIRLEAF JAMES 130 DIVISION ST DERBY CT 06418-1326 616-464-0027

1356329734 SIROKA PETER 1450 WASHINGTON BLVD STAMFORD CT 06902-9317 203-327-9321

1316046063 SISITSKY MICHAEL 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1073514873 SIVAKUMAR SUBBURAMAN 36475 5 MILE ROAD LIVONIA MI 48154-1971 800-645-3055

1285623025 SIVANESAN SIVA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1215907225 SKLAR CRAIG 1201 WEST MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4885

1598840068 SKOLNICK STANLEY 106 NOROTON AVE. DARIEN CT 06820-5237 203-655-8701

1326376187 SLANE ASSUNTA 2408 WHITNEY AVE HAMDEN CT 06518-3209 203-626-0160

1174898514 SLAUGHTER LEAH 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1265500532 SLIVKA RONALD 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7089

1841610664 SLOSHOWER JORDAN 300 GEORGE STREET YALE PSYCHIATRY NEW HAVEN CT 06511-6663 203-785-2095

1235453176 SLUTZMAN JONATHAN 55 LAKE AVENUE NORTH EMERGENCY MEDICINE WORCESTER MA 01655-0002 508-334-8890

1801204375 SMART HUNTER 4699 MAIN ST. SUITE200 BRIDGEPORT CT 06606-1851 203-372-3726

1316032931 SMEAD KENNETH VETERANS ADMINISTRATION CLINIC 4 SHAWS COVE SUITE 101 NEW LONDON CT 06320-4956 860-437-3611

1811156177 SMITH BENAY SILVER STREET BOX 351 MIDDLETOWN CT 06457-7023 860-262-5000

1194277558 SMITH BRENDAN 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-441-6767

1740571256 SMITH EDWARD 1600 S ANDREWS AVE FORT LAUDERDALE FL 33316-2510 954-847-4572

1528226750 SMITH ELIZABETH 1305 POST ROAD SUITE 310 FAIRFIELD CT 06824-6018 203-259-7709

1881761260 SMITH JOANN 1261 POST ROAD SUITE 200 - A FAIRFIELD CT 06824-6072 203-255-0770

1457345159 SMITH MATTHEW 455 TOLL GATE ROAD WARWICK RI 02228-2770 401-273-0641

1194773093 SMITH MELINDA 555 WILLARD AVE NEWINGTON CT 06111-2631 860-666-6951

1336187657 SMITH RICHARD 1101 NOTT ST SCHENECTADY NY 12308-2425 801-256-1900

1023557402 SMITH RUSSELL 759 CHESTNUT STREET SPRINGFIELD MA 01107-1619 413-794-5370

1578923231 SMITH SEAN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1366451155 SMITH THOMAS ONE TURKEY HILL ROAD SOUTH WESTPORT CT 06880-2621 646-737-2687

1679554513 SMULLIN STEVEN 166 CHERRY ST. NEW CANAAN CT 06840-4828 203-972-1581

1558370908 SNEAD ROBERT 6 GLEN COVE DRIVE ROCKPORT ME 04856-4240 800-645-3055

1104889823 SNEE GERALD 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1134174592 SNELLING LINDA 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-4201

1629036116 SNOWISE MARK 710 STOCKBRIDGE RD LEE MA 01238-9998 413-243-0122

1265535355 SNYDER AMY 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1003916974 SNYDER CHRISTOPHER 40 COMMERCE PARK SUITE 1 MILFORD CT 06460-3506 203-878-3531

1467748111 SO SOKPOLEAK 67 SANDPIT RD SUITE 308 DANBURY CT 06810-4032 631-445-0593

1104958438 SOBIERAJ WADHWA CHERYL 650 CHASE PARKWAY WATERBURY CT 06708-3046 203-597-8878

HUSKY Health Connecticut Page 56 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 57: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1245352863 SOBO HENRY 111 HIGH RIDGE RD STAMFORD CT 06905-3809 203-348-8805

1609849728 SOCHA CHRISTY 111 SALEM TURNPIKE SUITE 7 NORWICH CT 06360-6459 860-859-2262

1811946494 SOFAIR JANE 84 HOSPITAL AVENUE DANBURY CT 06810-6047 203-792-0400

1710995287 SOKARIS STEPHEN 1300 MASSACHUSETTS AVENUE TROY NY 12180-1619 623-241-8350

1740228535 SOKOLOSKI PAUL BREWSTER ROAD BRISTOL CT 06011-0977 440-627-2625

1205902210 SOLLACCIO PETER 352 7TH AVE RM 805 NEW YORK NY 10001-5189 212-255-1397

1538235791 SOLLINGER JONATHAN 1563 POST ROAD EAST WESTPORT CT 06880-5602 203-319-3939

1710933460 SOLOMON GARY 698 WEST AVE REHABILITATION CONSULTS PC NORWALK CT 06850-3302 203-523-0100

1477628618 SOMOZA CLARA 1101 NOTT ST SCHENECTADY NY 12308-2425 801-256-1900

1588652358 SOOD PARDEEP 5520 PARK AVENUE SUITE 303 TRUMBULL CT 06611-9999 203-743-7246

1487680831 SOOVAJIAN VICTORIA 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1356354088 SOSNER JULIAN 305 SEVENTH AVENUE SUITE 13C NEW YORK NY 10001-9423 212-633-1242

1336212885 SOTERO VINCENT 1224 MAIN ST SUITE ONE BRANFORD CT 06405-3778 203-483-9069

1699797290 SOUFER JOSEPH 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-528-9032

1891757738 SOWKA WILLIAM 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1417917964 SPADEA EDEN 26 QUEEN STREET WORCESTER MA 01610-2473 508-334-6556

1740225416 SPAK JAMES 888 WHITE PLAINS RD TRUMBULL CT 06611-4552 203-268-2882

1407956378 SPANOLIOS PARIS 40 COMMERCE PARK SUITE 1 MILFORD CT 06460-3506 203-878-3531

1518114222 SPARLIN SHERYL 900 BROADWAY BANGOR ME 04401-1900 207-907-3339

1700038858 SPARTA KHRISTINE 1881 POST RD FAIRFIELD CT 06824-5721 203-255-1036

1093816175 SPECTOR GARY 40 COMMERCE PARK SUITE 1 MILFORD CT 06460-3506 203-878-3531

1073553707 SPECTOR SCOTT 761 MAIN AVE NORWALK CT 06851-1080 203-853-9900

1619181674 SPECTOR STEVEN 790 SOUTH MAIN STREET PLANTSVILLE CT 06479-1555 860-321-2055

1215950662 SPELMAN JULIETTE 950 CAMPBELL AVENUE 11ACSL WEST HAVEN CT 06516-2770 866-808-7921

1336482884 SPENCER ANDREW 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1336309442 SPENCER TAYLOR 1101 NOTT ST SCHENECTADY NY 12308-2425 801-256-1900

1952369597 SPEVACK THEODORE 43 HIGH STREET WAREHAM MA 02571-2097 508-973-3584

1982685467 SPILLANE ERICA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1730306994 SPINELLA ANTHONY 1000 ASYLUM AVENUE SUITE 2106 HARTFORD CT 06105-1755 860-246-2541

1457447757 SPINELLI HENRY 875 5TH AVE NEW YORK NY 10065-4952 212-570-6235

1730269416 SPIRO CAROLYN 387 DANBURY RD WILTON CT 06897-2529 203-762-3881

1396702205 SPITALNIC STUART 11 FRIENDSHIP STREET NEWPORT RI 02840-2209 401-854-2508

1962439380 SPIVACK ADAM VA MEDICAL CENTER 555 WILLARD AVE., 3RD FL., MHC NEWINGTON CT 06111-2631 860-666-6951

1780775577 SPROVIERO JOSEPH 148 EAST AVENUE STE 3G NORWALK CT 06851-5727 203-838-4034

1033268602 SRIHARI VINOD 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1649596172 ST AMAND CHRISTOPHER 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1770744633 STAFF KRISTINE 2600 BRUCE B DOWNS BLVD WESLEY CHAPEL FL 33544-9207 800-645-3055

1477569713 STAHL BARBARA YALE-NEW HAVEN HOSPITAL 20 YORK STREET NEW HAVEN CT 06510-8039 203-785-2705

1780651919 STAMBAUGH ROBERT 736 N BATTLEFIELD BLVD CHESAPEAKE VA 23320-4941 800-633-2243

1689984163 STARACE-COLABELLA LINDA 55 LOCK STREET NEW HAVEN CT 06511-3603 203-432-0076

1619385390 STARCZAK KONRAD 250 PLEASANT STREET EMERGENCY DEPT CONCORD NH 03301-7539 951-430-1497

1669436820 STARK JACK 132 MAIN ST DANBURY CT 06810-7863 203-794-1979

1760658264 STARK JAMES 521 WEST 57TH STREET-4TH FLR NEW YORK NY 10019-2929 646-557-3847

1225180771 STARR CAROL 41 NORTH MAIN STREET SUITE 210 WEST HARTFORD CT 06107-1929 860-313-0818

1982655593 STASKO KARA 55 FRUIT ST BOSTON MA 02114-2696 617-726-8396

HUSKY Health Connecticut Page 57 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 58: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1699737536 STAWIECKI JEANNE 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1659539666 STCYR NICOLE 136 WEST MAIN STREET FIRST FLOOR NEW BRITAIN CT 06051-1315 860-826-4763

1033125166 STEELE DALE 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1114945623 STEELE MAUREEN 31 RIVER ROAD SUITE 200 COS COB CT 06807-2152 845-639-0007

1811063027 STEIN GARY CAPITOL REGION MENTAL HEALTH C 500 VINE STREET HARTFORD CT 06112-1639 860-297-0999

1033371984 STEIN JULIE 725 NORTH STREET PITTSFIELD MA 01201-4019 413-447-2752

1609904960 STEIN SANDERS 2777 SUMMER ST SUITE 504B STAMFORD CT 06905-4318 203-232-4008

1023173341 STEINER JEANNE 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1417069543 STEINHARDT MINDI 397 BRIDGEPORT AVENUE MILFORD CT 06460-4151 203-877-0112

1821085382 STERLING ROBERT 825 HIGH RIDGE RD STAMFORD CT 06905-1904 203-322-3700

1871688531 STERN JEFFREY 51 DEPOT ST SUITE 201 WATERTOWN CT 06795-2667 860-274-2418

1639501331 STEVENS REBECCA 300 LONGWOOD AVENUE BOSTON MA 02115-5724 617-355-8537

1043392178 STEWART MICHAEL 119 BELMONT STREET WORCESTER MA 01605-2903 508-334-8152

1952374241 STEWART MICHAEL 455 TOLL GATE ROAD WARWICK RI 02886-2791 401-273-0641

1508952219 STIDHAM KATRINA 19 BRADHURST AVENUE SUITE 3600S HAWTHORNE NY 10532-2140 914-693-7636

1659432029 STILLMAN MARGARET CHILDREN'S & WOMAN'S PHYSICIAN 150 WHITE PLAINS RD STE 101 TARRYTOWN NY 10591-5521 914-922-2241

1649287665 STITELMAN MICHAEL 155 MEADOW ST BRANFORD CT 06405-3656 203-481-4637

1053410712 STOCKER RALPH 85 SEYMOUR STREET SUITE 1003 HARTFORD CT 06106-5529 860-246-4260

1649272683 STOCKHEIM JANET CHILDREN'S & WOMAN'S PHYSICIAN 19 BRADHURST AVE. STE 2400 HAWTHORNE NY 10532-2144 914-922-2241

1386892354 STOLZENBERG JONATHAN 32 ARLINGTON RD WEST HARTFORD CT 06107-1603 860-521-5685

1053346924 STONE JOHN 55 FRUIT ST YAW 2 BOSTON MA 02114-2696 617-726-7938

1760558944 STORM KITTY 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1689632739 STOUT BRIAN 5151 N. 9TH AVENUE PENSACOLA FL 32504-8721 850-416-6961

1700812351 STRACKE LOTHAR 1101 NOTT ST. SCHENECTADY NY 12308-2425 801-256-1900

1700888450 STRASSBERG SONYA CHILDREN''S & WOMAN''S PHYSICI 100 WOODS RD VALHALLA NY 10595-1530 914-922-2241

1245386663 STRASSBERGER GERALD 16 RIVER STREET NORWALK CT 06850-3402 203-853-2545

1285605998 STRAUS DAVID 1275 YORK AVENUE BOX 441 NEW YORK NY 10065-6007 212-639-8365

1669432258 STREETER GORDON 55 LOCK STREET NEW HAVEN CT 06511-3603 203-432-0076

1164516415 STRINGEL GUSTAVO CHILDREN'S & WOMAN'S PHYSICIAN 19 BRADHURST AVE. STE 1400 HAWTHORNE NY 10532-2144 914-922-2241

1578596375 STROE ANGELA 75 SEMINARY HILL RD. CARMEL NY 10512-1921 845-225-3400

1124019815 STRONG VIVIAN 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1629250246 STRUBBE REBECCA SOUTH BRITAIN RD SOUTHBURY CT 06488-0901 203-586-2000

1457441321 STUCKEY ASHLEY 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1689725087 STUNTZ JR RICHARD 435 LEWIS AVENUE MERIDEN CT 06451-2101 203-694-8630

1649200676 STUPIK STEPHEN 60 HOSPITAL ROAD LEOMINSTER MA 01453-2205 508-793-6348

1356459093 SU EDWIN 535 EAST 70TH STREET NEW YORK NY 10021-4823 646-707-8471

1538235163 SUBRAMANIAN SHIELA 173 EAST AVE NEW CANAAN CT 06840-5614 203-972-4236

1427286715 SUCHENSKI MAUREEN 455 TOLL GATE ROAD WARWICK RI 02886-2759 401-921-7362

1083928006 SUDERIO-TIRONE ELAINE CHILDREN'S & WOMENS PHYSICIAN VASSAR BROTHERS HOSP.45READE POUGHKEEPSIE NY 12601-3947 914-922-2241

1114997137 SUGIN STEPHANIE 1201 WEST MAIN STREET SUITE 100 WATERBURY CT 06708-3105 203-573-4885

1861483414 SUHOCKI DAVID ADVANCED DERMATOLOGY CENTER 464 WOLCOTT ROAD WOLCOTT CT 06716-2626 203-879-6171

1235305780 SUKUMARAN ANAND 55 LOCK ST MENTAL HEALTH & COUNSELING NEW HAVEN CT 06511-8237 203-432-0390

1801130901 SULLIVAN JENNIFER 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1710277587 SULLIVAN KEVIN 800 OAK ST FARMVILLE VA 23901-1199 800-645-3055

HUSKY Health Connecticut Page 58 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 59: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1003879008 SULLIVAN MATTHEW 100 AIRPORT RD KINSTON NC 28501-1604 800-645-3055

1114037504 SUNER SELIM 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1013015809 SUNG JENNY CHILDREN'S & WOMAN'S PHYSICI 45 READE PL POUGHKEEPSIE NY 12601-3947 914-922-2241

1730131574 SUPPLEE ROBERT 169 MARTIN AVE. EPHRATA PA 17522-1002 623-241-8321

1437193604 SUREDDI PRASAD 10 MAIN STREET SOUTH SOUTHBURY CT 06488-2260 203-264-6334

1528357852 SUTARIA RAVI 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1083886154 SWANSON SUSAN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1659337038 SWEENEY CHRISTOPHER 450 BROOKLINE AVENUE DANA-FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1912157322 SWEETPEREZ JULIE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1427093145 SWOBODA JENNIFER 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1013958057 SWORDS ROBERT 140 GLASTONBURY BLVD GLASTONBURY CT 06033-4459 860-674-1778

1275886293 SYLVIA KAREN 1680 ALBANY AVE HARTFORD CT 06105-0610 860-297-4511

1639127749 SYLVIA LISA 29 LEWIS STREET GREAT BARRINGTON MA 01230-1713 413-447-2752

1366409450 SZAKACS GAIL 3 HOLLYHOCK RD WILTON CT 06897-4443 203-834-2813

1770965345 SZCZUR RACHEL 759 CHESTNUT STREET SPRINGFIELD MA 01199-1619 413-794-3233

1417020686 SZILAGYI NATHALIE 230 SOUTH FRONTAGE ROAD YALE MEDICINE CHILD STUDY CTR NEW HAVEN CT 06519-1124 203-737-7129

1376535757 TAFT SUSAN 308 CALLAHAN RD NORTH KINGSTOWN RI 02852-9999 401-567-0800

1518100528 TAKAYASU KATHERINE 32 STRAWBERRY HILL COURT STAMFORD CT 06902-2594 203-276-2185

1467816033 TALIADOROS PARASREVI 759 CHESTNUT STREET SPRINGFIELD MA 01107-1619 413-794-3233

1639165889 TAN TEANSU 1600 S ANDREWS AVENUE FORT LAUDERDALE FL 33316-2510 954-847-4572

1851606966 TANEJA VIKAS 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1629041728 TANKSLEY RADFORD 111 SALEM TURNPIKE SUITE 7 NORWICH CT 06360-7403 860-859-2262

1659377471 TANNENBAUM LAWRENCE 305 CHURCH ST SUITE 3 NAUGATUCK CT 06770-2836 203-729-5741

1730589292 TARASOVIC LINDSAY 950 CAMPBELL AVE BUILDING 1 GROUND FLOOR G101 WEST HAVEN CT 06516-2770 203-932-5711

1033314406 TAUSEVICH DAVID 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1467826693 TAVERAS CRYSTAL 1 RIVER STREET THUNDERMIST HEALTH CENTER WAKEFIELD RI 02879-3214 401-767-4100

1548292188 TAYLOR GLENN 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1710966130 TAYLOR JACKIE 620 SKYLINE DR JACKSON TN 38301-3923 623-582-2141

1669483939 TAYLOR STEPHANIE 300 SUMMIT ST TRINITY COLLEGE HEALTH CENTER HARTFORD CT 06106-3100 860-297-2018

1649452806 TAZELAAR JAMES 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1811222300 TEAPE DANIELLA 20 YORK STREET YNHH PULMONOLGY NEW HAVEN CT 06510-3220 203-688-4242

1558426478 TEEKING DENNIS 184 MT. PLEASANT RD NEWTOWN CT 06470-1408 203-426-0500

1134265044 TEK CENK 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1316258304 TEKMYSTER GENE 888 WHITE PLAINS ROAD TRUMBULL CT 06611-4552 203-268-2882

1679736169 TELLECHEA CRISTINA BOX 351 - PAGE HALL 2ND FL 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1801820477 TEMPEL RICHARD 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1508871310 TENENBOYM TATYANA 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1386958346 TERKELL SHANNON 1011 VETERANS MEMORIAL PARKWAY EAST PROVIDENCE RI 02915-5061 401-444-4171

1770577298 TERLATO JOSEPH 1351 S COUNTY STE 115 EAST GREENWICH RI 02181-5079 401-421-4000

1609006527 TERRY YUSEF 759 CHESTNUT STREET S4628 SPRINGFIELD MA 01199-1619 413-794-5550

1154450450 TESLUK CATHERINE 240 BRADLEY ST NEW HAVEN CT 06510-1108 203-562-4942

1154388361 TESORO MICHAEL 152 EAST STREET SHARON CT 06069-2415 860-364-5615

1861698425 THABET ASHRAF 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1437361870 THAKKAR VATSAL 1720 POST RD E. SUITE 223 WESTPORT CT 06880-5643 203-220-6390

1659307106 THANKAPPAN KUNJATHAN 380 MAIN STREET SUITE 4 WATERTOWN CT 06795-1809 860-274-7304

HUSKY Health Connecticut Page 59 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 60: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1679624712 THARPE JACOB 119 BELMONT STREET WORCESTER MA 01605-2903 508-793-6348

1093933681 THELISSA HARRIS 682 PROSPECT AVE HARTFORD CT 06105-4238 860-236-2320

1619104502 THODIYIL PAUL 1ST AVE @ 16TH STREET NEW YORK NY 10003-2929 212-844-6212

1508304619 THOLE AMANDA 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-443-7552

1649290289 THOMAS ERIC 11 SOUTH MAIN STREET MIDDLETOWN CT 06457-3646 860-347-4555

1770621435 THOMAS GARY 10 UNION SQUARE EAST SUITE 4K NEW YORK NY 10003-3314 646-602-8030

1013985118 THOMAS MICHAEL 3401 N. BROAD ST PHILADELPHIA PA 19140-5103 215-707-1429

1215028139 THOMAS RONALD ST. MARY''S HOSPITAL 56 FRANKLIN STREET WATERBURY CT 06706-1253 215-442-5046

1558529255 THOMPSON KATHRYN 4 CORPORATE DRIVE SUITE 386 SHELTON CT 06484-6211 203-538-5682

1861471088 THOMPSON ROBERT 100 WELLS STREET SUITE 1B HARTFORD CT 06103-2920 860-249-4466

1942265277 THOMPSON WILLIAM 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1043233240 THOMSEN JEFFREY 55 TOWN LINE ROAD SUITE 202 WETHERSFIELD CT 06109-4352 860-529-5280

1861411530 THOMSON DONALD 725 NORTH ST PITTSFIELD MA 01201-4132 413-447-2752

1588071476 THORNTON BRITTANY 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1689609497 THORNTON KATHERINE 450 BROOKLINE AVENUE DANA FARBER CANCER INSTITUTE BOSTON MA 02215-5418 617-632-5917

1790709467 THURLING DENISE 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1174676837 TIBERI THOMAS 3015 MAIN STREET BRIDGEPORT CT 06606-4215 203-365-0015

1992764849 TICHENOR LISA 1700 SOUTH TAMIAMI TRAIL SARAOSTA FL 34239-3509 800-645-3055

1740363779 TICKEY GARY 64 ROBBINS STREET WATERBURY CT 06708-2613 215-442-5046

1407970254 TIE KAREN 555 WILLARD AVENUE NEWINGTON CT 06111-6131 860-667-6763

1023394657 TIEMO AEMI 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-443-7552

1740201854 TILMAN KERI 11 FRIENDSHIP STREET NEWPORT RI 02840-2209 401-854-2508

1265486864 TIRADOGONZALEZ ALFREDO 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1427002450 TIRHEIMER III WENZEL 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1740662154 TIVNAN MELISSA 119 BELMONT STREET UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01605-2903 508-334-8515

1275590150 TOBACK GREGORY 190 HEMPSTEAD STREET NEW LONDON CT 06320-6248 860-443-2428

1881773976 TOBKES JONATHAN 115 EAST 61ST STREET SUITE 7F NEW YORK NY 10065-8185 212-861-0763

1265410351 TOGNACCI EDWARD 3269 STOCKTON HILL RD KINGMAN AZ 86409-3619 800-633-2243

1396773511 TOKSOY JOHN 55 LOCK STREET NEW HAVEN CT 06511-2837 203-432-0075

1275515371 TOKUNO HAJIME VA CONNECTICUT HEALTHCARE SERV 950 CAMPBELL AVE WEST HAVEN CT 06516-2770 203-937-4724

1770522807 TOM MICHAEL 984 N BROADWAY STE 400 YONKERS NY 10701-1308 914-963-8588

1235190984 TORTORA PETER 1300 POST RD SUITE 202 FAIRFIELD CT 06824-6038 203-255-8827

1558309799 TOTA ROBERT 1635 CENTRAL AVENUE BRIDGEPORT CT 06610-2717 203-551-7464

1932186376 TOUIJER KARIM 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1801833009 TRACY STEPHEN 29 LEWIS AVE GREAT BARRINGTON MA 01230-1713 413-447-2752

1780769919 TRACY TODD 40 COMMERCE PARK SUITE 1 MILFORD CT 06460-3506 203-878-3531

1780659292 TRACY III DMD DANIEL 100 FANNING AVENUE NORWICH CT 06360-2943 860-892-4996

1659734127 TRAFTON SARAH DANA FARBER CANCER INSTITUTE 450 BROOKLINE AVENUE BOSTON MA 02215-5418 617-632-5917

1235289190 TRAILOR CHRISTOPHER 130 NEW LONDON TPKE. NORWICH CT 06360-0130 860-889-3889

1851554331 TRAVERSO PURNELL 195 EASTERN BOULEVARD SUITE 200 GLASTONBURY CT 06033-1208 860-781-6285

1447396973 TREADO ROBERT 670 EAST ROAD BRISTOL CT 06010-6845 860-589-0874

1558550517 TREANTAFILOS MARIANNE 39 OLD RIDGEBURY RD DANBURY CT 06810-5103 203-702-7400

1083637060 TRESS MICHAEL CAPITOL REGION MENTAL HEALTH C 500 VINE STREET HARTFORD CT 06112-1639 860-297-0909

HUSKY Health Connecticut Page 60 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 61: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1225145006 TREWORGY SCOTT 93 CAMPUS AVE LEWISTON ME 04240-6030 888-851-7590

1619223955 TREXLER JAMIE 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7089

1396733515 TRIMBLE JOHN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1881641512 TRITOS NICHOLAS ZERO EMERSON PLACE STE 112 BOSTON MA 02114-2217 617-726-7948

1376638254 TRODDYN MICHAEL 281 LINCOLN STREET WORCESTER MA 01605-2138 508-793-6348

1396198420 TROSHIN VLADISLAV 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1720098247 TROWBRIDGE RANDY 22 EAGLE ROAD DANBURY CT 06810-4129 203-778-8326

1518279736 TROY LISA CHILDREN'S & WOMAN'S PHYSICI 171 RAMAPO RD GARNERVILLE NY 10923-1552 914-922-2241

1548295389 TRUMMEL JOHN 1 MEDICAL CENTER DR LEBANON NH 03756-0001 603-650-5000

1851353551 TSANG BRIAN 200 MILL ROAD FAIRHAVEN MA 02719-5208 508-973-3584

1609850742 TSENG DANIEL 57 NORTH STREET STE 201 DANBURY CT 06810-5660 203-792-3316

1356395966 TUBBS ROBERT 593 EDDY STREET PROVIDENCE RI 02903-4923 401-854-2504

1275648552 TUCKER EDWARD 67 NORTH MAIN ST ESSEX CT 06426-0132 860-767-1411

1609856020 TULACRO JAMES 1351 WASHINGTON BLVD STAMFORD CT 06902-9317 203-276-2000

1861584575 TUMENIUK ALEXANDER 345 BOSTON POST ROAD MILFORD CT 06460-2528 203-876-2696

1972799799 TUNG DAVID 3180 MAIN ST, SUITE 303 CORE PHYSICAL THERAPY BRIDGEPORT CT 06606-4237 203-373-1593

1376668178 TUREK THOMAS 1389 WEST MAIN ST SUITE 208 WATERBURY CT 06708-3115 203-757-1287

1770975310 TURENNE ELIZABETH 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1437385481 TURNER CAROL 1 ELMCROFT ROAD STAMFORD CT 06926-0700 203-351-7700

1356312854 TUTTLE ROBERT 1275 YORK AVE NEW YORK NY 10065-6007 646-227-3813

1154383842 TYER JAMES 60 HOSPITAL ROAD LEOMINSTER MA 01453-2205 508-793-6348

1083731665 TYSON VEDA 126 MORGAN STREET STAMFORD CT 06905-5478 917-533-0542

1689732067 ULLES MONICA 300 LONGWOOD AVE BOSTON MA 02115-5724 617-355-8537

1811124886 ULRICH DAVID 615 S. NEW BALLAS ROAD SAINT LOUIS MO 63141-8221 314-364-3829

1205904281 UMASHANKAR SHANTALA 401 WEST THAMES ST BLDG 301 NORWICH CT 06360-7167 860-859-4646

1215914429 UNKENHOLZ KARL 1101 NOTT ST SCHENECTADY NY 12308-2425 801-256-1900

1023092327 UPCHURCH KATHERINE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-8890

1831131531 URBAN KURT 636 DEL PRADO BLVD CAPE CORAL FL 33990-2695 800-645-3055

1518098375 UY GEORGE 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1619278132 UYEKLIONG MARC 400 CAPITAL BLVD ROCKY HILL CT 06067-3576 415-547-5151

1104075316 VALA BHAVIK 7050 GALL BLVD ZEPHYRHILLS FL 33541-1347 800-645-3055

1013273317 VALENCIA CELESTE 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1700966306 VALLUZZO THOMAS 57 NORTH STREET SUITE 318 DANBURY CT 06810-5628 203-794-0419

1154348621 VAN PELT MARIA 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-793-6348

1811242381 VAN SCHALKWYK GERRIT IAN YALE HOUSESTAFF OFFICE 20 YORK STREET ROOM 222 NEW HAVEN CT 06510-3220 203-688-9503

1891723003 VAN SMITH CHRISTOPHER 3000 CORAL HILLS DRIVE CORAL SPRINGS FL 33065-4100 954-837-4572

1861666539 VANASSE REBECCA 11 WELLS ST WESTERLY RI 02891-2998 401-273-0641

1487992343 VANDERVELDE KRISTEN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1932113081 VANEGAS LUISA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1114213410 VARAMO VINCENT 455 TOLL GATE ROAD WARWICK RI 02886-9252 401-273-0641

1104196211 VARMA SHILPIKA 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1023234002 VARUGHESE MATTHEW 100 PARK STREET GLENS FALLS NY 12801-4413 801-256-1900

1558425678 VASILE JULIE 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1750489290 VASQUEZ LUZ 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2700 203-932-5711

1629305537 VAZ SANDRA 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

HUSKY Health Connecticut Page 61 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 62: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1255449716 VAZQUEZ BLANCA 223 EAST 34TH ST. 14 WALL STREET, 9TH FLOOR NEW YORK NY 10016-4852 646-207-5287

1508807603 VEKSLER OFFENGENDEN IRENA 55 WALLS DRIVE STE. 405 FAIRFIELD CT 06824-5163 203-259-7070

1881850360 VELASCO JASON 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1962402156 VELEZ-DOMENECH GILBERTO CHILDREN''S & WOMAN''S PHYSICI 503 GRASSLANDS RD STE 200 VALHALLA NY 10595-1593 914-922-2241

1497848311 VIGIL TERESA 2211 LOMAS BLVD NE ALBUQUERQUE NM 87106-2745 800-633-2243

1861440901 VILAR ROLAND CHILDREN''S & WOMAN''S PHYSICI 70 DUBOIS ST. NEWBURGH NY 12550-4851 914-922-2241

1831257799 VILLA JOSE 223 GLENBROOK ROAD STAMFORD CT 06906-2514 203-359-9039

1134443815 VILLEGAS MAEROSANNE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1285723627 VIOLA ANTHONY 226 WHITE ST DANBURY CT 06810-6814 203-797-1500

1598194763 VIRDEE KULVEEN 8 LINCOLN ST WESTPORT CT 06880-4201 203-916-4600

1417147406 VISCHIO JOHN 85 SEYMOUR STREET SUITE 1003 HARTFORD CT 06106-5529 860-246-4260

1225006505 VITALE MIRIAM 950 CAMPBELL AVENUE - 116A9 PSYCH PRIMARY CARE (PPCC) WEST HAVEN CT 06516-2770 203-932-5711

1225155021 VOEGTLI KRYSTYNA 3100 EAST FLETCHER AVENUE TAMPA FL 33613-4613 800-645-3055

1366532343 VOGEL GERALD CHILDREN'S & WOMAN'S PHYSICI 4C MEDICAL PARK DRIVE POMONA NY 10970-3516 914-922-2241

1184797151 VOGEL SARAH 2215 BURDETT AVE TROY NY 12180-2466 518-271-3450

1023102068 VONBLEICKEN JACLYN 157 UNION STREET MARLBOROUGH MA 01752-1228 508-793-6348

1518955517 VOSBURGH EVAN 800 HOWARD AVE YALE UNIVERSITY NEW HAVEN CT 06519-0309 203-785-4216

1013998244 VOSS KERSTIN 29 LEWIS STREET GREAT BARRINGTON MA 01230-1713 413-881-5427

1477991727 VOUKIDES ALICIA 24 PUTNAM PIKE DAYVILLE CT 06241-1646 860-779-1230

1639245269 VOYTOVICH JULIA 173 EAST AVENUE NEW CANAAN INTERNAL MED LLC NEW CANNAN CT 06840-5695 203-972-4240

1790970408 VREES ROXANNE 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1780052993 VU LAN 759 CHESTNUT STREET SPRINGFIELD MA 01199-1619 413-794-4320

1053637728 VUKOVIC JOSEPH 600 NORTHERN BLVD ALBANY NY 12204-1004 800-645-3055

1639210479 WAHL REBECCA CONNECTICUT VALLEY HOSPITAL BOX 351 - 1000 SILVER STREET MIDDLETOWN CT 06457-7023 860-262-5868

1164480323 WAITZE ALAN 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1568431658 WALD DAVID 3401 N BROAD ST PHILADELPHIA PA 19140-5103 215-707-1429

1679630446 WALDREP DONALD 215 WEST JANSS ROAD THOUSAND OAKS CA 91360-1847 888-851-7590

1114913894 WALDSTREICHER STUART 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1770683013 WALKER W. SCOTT 1 RANDALL SQUARE PROVIDENCE RI 02904-2709 401-273-0641

1609838689 WALLINGTON DALE 1216 FARMINGTON AVE SUITE 303 WEST HARTFORD CT 06107-2673 860-313-5380

1437475928 WALLS KRISTEN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-334-8152

1699869644 WALSH KATHLEEN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1114313707 WANG CHARLOTTE 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-442-6534

1225258338 WANG JEFF 100 TECHNOLOGY DRIVE SUITE 210 TRUMBULL CT 06611-6303 203-880-5416

1013008317 WANG LOUIS 80 SOUTH MAIN STREET SUITE 102 MIDDLETOWN CT 06457-3648 860-344-1401

1962449512 WANG TIMOTHY 136 WEST MAIN STREET FIRST FLOOR NEW BRITAIN CT 06051-1315 860-826-4763

1699066019 WARD REGINALD 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1386626133 WARMAN MARC 409 MOUNTAIN LAUREL ROAD FAIRFIELD CT 06824-2424 203-216-0178

1336245737 WARNER KAREN 85 CHURCH ST SUITE 600 MIDDLETOWN CT 06457-3647 860-347-5333

1740405885 WARREN ROBERT 990 BROOKLAWN AVE BRIDGEPORT CT 06604-1205 203-335-6471

1477528842 WARTELLA JOHN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1336469170 WARYASZ GREGORY 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-3581

1376578880 WASKIEWICZ CHERYL 131 ENGLEWOOD DRIVE ORANGE CT 06477-2434 203-988-7895

1487792305 WASKO KIM 140 WILLOW STREET SUITE 2 SUITE 2 WINSTED CT 06098-2092 860-379-4809

HUSKY Health Connecticut Page 62 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 63: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1588988414 WASSER TOBIAS ST VINCENT''S MULTISPECIALTY G 47 LONG LOTS RD WESTPORT CT 06880-3828 203-341-5832

1538406905 WATKINS LUCAS 20 YORK STREET YNHH TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1649298142 WATSKY KALMAN 330 ORCHARD STREET NEW HAVEN CT 06511-4405 203-789-4045

1063558088 WATSKY NANCY 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1740212323 WATSON FREDERICK 500 CHASE PARKWAY WATERBURY CT 06708-3346 203-755-6677

1538405923 WATSON MICHELLE 30 SHELBURNE RD STAMFORD CT 06902-3628 203-276-7058

1962763656 WATSON SARA 1 RIVER STREET THUNDERMIST HEALTH CENTER WAKEFIELD RI 02879-3214 401-767-4100

1588738256 WAYNIK MARK 52 BEACH RD SUITE 102 FAIRFIELD CT 06824-6017 203-254-2000

1407144314 WEAGRAFF NATHAN 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1902946890 WEAVER JACQUELINE 2215 BURDETT AVE TROY NY 12180-2466 518-271-3450

1912989914 WEBB JANET 455 CHASE PARKWAY 3RD FLOOR WATERBURY CT 06708-2613 203-578-3940

1528366739 WEBSTER JENNIFER 55 FRUIT ST BOSTON MA 02114-2696 617-726-2330

1689676405 WEEKS LONG JANIE 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1083740732 WEI NANCY 50 STANIFORD ST 3RD FLOOR BOSTON MA 02114-2517 617-726-8722

1821027244 WEILAND DANIEL 888 WHITE PLAINS RD TRUMBULL CT 06611-4552 203-268-2882

1831106228 WEINBERGER JEFFREY 25 MILTIADES AVE RIVERSIDE CT 06878-2007 203-637-0072

1649343807 WEINER GAIL 8 W END AVE OLD GREENWICH CT 06870-1642 203-637-3212

1154713683 WEINREB STEVEN 780 SUMMER STREET STAMFORD CT 06901-1089 203-388-1571

1942362009 WEISBERG MICHAEL 71 PROSPECT AVE HUDSON NY 12534-2907 801-256-1900

1750597340 WEISS BARRY 60 WASHINGTON AVE # 207 HAMDEN CT 06518-3273 203-288-5916

1619052131 WEISS DAVID 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1649484445 WEISS ERICA 291 WHITNEY AVE, SUITE 404 NEW HAVEN CT 06511-3765 203-376-1165

1891882692 WEISS JOSEPH 241 W MAIN ST NEW BRITAIN CT 06052-1393 860-222-2222

1649307778 WEISS WUERTH JANA 175 COPSE RD MADISON CT 06443-2323 203-245-2778

1033209804 WEISSMAN EVAN CHILDREN''S & WOMAN''S PHYSICI 4C MEDICAL PARK DRIVE POMONA NY 10970-3516 914-922-2241

1871511725 WELBY MELISSA 99 CHERRY ST UNIT D MILFORD CT 06460-3455 203-906-6294

1174741656 WELCH JENNIFER 593 EDDY STREET PROVIDENCE RI 02903-4923 401-444-8219

1508887290 WELLNER MURRAY 10 DALE STREET WEST HARTFORD CT 06107-1815 860-521-9451

1619967817 WELT CORRINE 55 FRUIT ST BHX 511 BOSTON MA 02114-2696 617-726-8433

1235139684 WELTER JOHN CHILDREN'S & WOMAN'S PHYSICI 19 BRADHURST AVE. STE 1400 HAWTHORNE NY 10532-2140 914-922-2241

1578713426 WELZBACHER KATY 455 TOLL GATE RD WARWICK RI 02886-2759 401-737-7000

1053393496 WEN PATRICK 450 BROOKLINE AVE DA2108A BOSTON MA 02215-5450 617-632-3965

1851461214 WENICK GARY 2050 ROUTE 22 BREWSTER NY 10509-5948 914-242-5621

1144336215 WERBLIN ROBERT 4 FULLER STREET ALEXANDRIA BAY NY 13607-1316 800-633-2243

1487642005 WEREMCHUK MAR 210 NEW LONDON TPKE GLASTONBURY CT 06033-2906 860-633-1543

1295783819 WESPISER ROBERT 620 LAUREL STREET LAUREL LAKE NURSING HOME LEE MA 01238-9316 413-243-0122

1639167976 WEST HAROLD 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1487606117 WEST JOHN 34 WATER STREET SUITE 2 MYSTIC CT 06355-2524 860-572-9994

1346431657 WESTPHAL ALEXANDER 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016

1750309308 WEXLER BRUCE 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016

1376637322 WHALEY PAUL 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1265459143 WHARTON GARY 235 PLAIN ST SUITE#401 PROVIDENCE RI 02905-3240 401-273-0641

1356442404 WHEELER LAUREN 759 CHESTNUT STREET SPRINGFIELD MA 01199-1619 413-794-4022

1912103573 WHITE JEREMY 1395 S. PINELLAS AVENUE TARPON SPRINGS FL 34689-3790 800-645-3055

1407017684 WHITE JOSHUA 246 PLEASANT STREET SUITE 104 CONCORD NH 03301-2548 603-230-1939

HUSKY Health Connecticut Page 63 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 64: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1043288061 WHITMAN GAIL 2890 MAIN STREET SUITE C STRATFORD CT 06614-4980 203-375-8200

1396196341 WHITNEY JON 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-441-6767

1922074020 WICHMAN KENNETH 117 E. CENTER ST MANCHESTER CT 06040-5246 860-649-3338

1124087903 WICHMANN EUGEN 55 WHITING ST. SUITE 2C PLAINVILLE CT 06062-2262 860-747-5529

1215092440 WICKS CHARLES 246 PLEASANT STREET SUITE 103 CONCORD NH 03301-2548 603-224-6070

1891045423 WIEBE JEFFREY 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1114309911 WIEGAND JOANNA 5300 KIDSPEACE DRIVE OREFIELD PA 18069-2044 610-799-7089

1376587766 WIEMER DAVID 9 COTS STREET SUITE 2A SHELTON CT 06484-3866 203-924-8922

1912928524 WIENER MICHELE 75 SEMINARY HILL RD. CARMEL NY 10512-1921 845-225-3400

1104884907 WIGDEN BETH 761 WORCESTER ROAD FRAMINGHAM MA 01701-5207 508-872-1107

1962409417 WILCHINSKY MARK 888 WHITE PLAINS RD TRUMBULL CT 06611-4552 203-268-2882

1558417576 WILCOX GREGG 47 BINGHAM ROAD CANTERBURY CT 06331-1924 860-774-0876

1619137288 WILDY JONATHAN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1942646161 WILEY MELORA 1 LONG WHARF DRIVE YNHH PEDIATRIC DEVELOPMENT NEW HAVEN CT 06511-5991 203-785-7521

1396863981 WILHELMS KATHRYN 5 MELROSE DRIVE FARMINGTON CT 06032-2251 860-677-1316

1588026702 WILKINS CURTIS 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6556

1023122116 WILKS MATTHEW 3001 BROADMOOR BLVD NE RIO RANCHO NM 87144-2100 505-272-3295

1073589396 WILLIAMS CARLA 159 WEST PUTNAM AVENUE GREENWICH CT 06830-5329 203-869-7080

1104841501 WILLIAMS DEAN 1397 WEIMER ROAD TAOS NM 87571-6253 800-633-2243

1700052446 WILLIAMS ELIZABETH 55 FRUIT ST GRB 444 BOSTON MA 02114-2696 617-726-3030

1831222629 WILLIAMS ELLEN 287 WEST ST STATE OF CT DVA ROCKY HILL CT 06067-3501 860-616-3778

1598878134 WILSON JASON 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1740257252 WILSON JEANNE CHILDREN''S & WOMAN''S PHYSICI 19 BRADHURST AVE. STE 2400 HAWTHORNE NY 10532-2144 914-922-2241

1992121420 WILSON JULIET 725 NORTH STREET PITTSFIELD MA 01201-4019 413-447-2752

1285632794 WILSON MARK 330 WEST 58TH STREET SUITE 313 NEW YORK NY 10019-1821 917-441-2344

1184984072 WILSON TANEISHA 593 EDDY STREET UNIVERSITY EMERGENCY MEDICINE PROVIDENCE RI 02903-4923 401-854-2504

1407996986 WINACOO JEFFREY 55 LAKE AVENUE NORTH WORCESTER MA 01655-0001 508-793-6348

1134663958 WINDER VANESSA 500 ENTERPRISE DRIVE ROCKY HILL CT 06067-3913 615-224-5005

1902897911 WINICKOFF RICHARD 165 CAMBRIDGE ST STE 501 BOSTON MA 02114-2723 617-726-4900

1629141353 WINKLER ALAN CHILDREN'S & WOMEN'S PHYSICIAN 688 POST RD SCARSDALE NY 10583-5059 914-725-5252

1043537624 WINKLER JASON CHILDREN'S & WOMEN'S PHYSICIAN 688 POST RD SCARSDALE NY 10583-5059 914-725-5252

1265759831 WINKLER SETH CHILDREN'S & WOMEN'S PHYSICIAN 688 POST RD SCARSDALE NY 10583-5059 914-725-5252

1922186840 WINTERS THOMAS 1385 HANCOCK ST QUINCY MA 02169-5103 617-770-7882

1346355989 WITTENBERG ALISON 60 WASHINGTON AVE SUITE 102 HAMDEN CT 06518-3271 203-407-6444

1174636724 WOHL AARON 2776 CLEVELAND AVE FORT MYERS FL 33901-5864 800-645-3055

1447413505 WOHLRAB KYLE 101 DUDLEY STREET 5TH FLOOR PROVIDENCE RI 02905-2401 401-273-0641

1851474068 WOJCIK JOHN 3300 MAIN STREET, 3RD FL C&D SPRINGFIELD MA 01199-1619 413-794-7033

1376551051 WOLFE ANDREW 1351 WASHINGTON BLVD SUITE 101 STAMFORD CT 06902-2419 203-327-5808

1538120597 WOLFE SCOTT 535 E. 70TH ST. NEW YORK NY 10021-4823 646-797-8471

1710903521 WOLFSON DANIEL 528 WASHINGTON HIGHWAY MORRISVILLE VT 05661-8973 588-482-9600

1184795759 WOLFSON ELLEN 35 RIVER ROAD COS COB CT 06807-2716 203-625-0333

1285805812 WOLFSON WENDY 21 LOCUST AVE NEW CANAAN CT 06840-5327 917-499-8250

1891101960 WOLK SARAH 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

HUSKY Health Connecticut Page 64 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 65: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1104857770 WOLL MICHAEL 20 YORK STREET YNHH - TOMPKINS 2, RM 226 NEW HAVEN CT 06510-3220 203-688-9503

1588644033 WOLMER MARK 62 NORTH ST DANBURY CT 06810-5620 203-792-2020

1013175439 WON ELIZABETH 500 WESTCHESTER AVENUE WEST HARRISON NY 10604-3200 646-227-3813

1134188246 WONDEMUNEGNE TIRUWORK 4422 3RD AVE BRONX NY 10457-2545 800-645-3055

1912994666 WONG JAMES 102 EAST AVE NORWALK CT 06851-5010 203-838-4119

1447256144 WONG JANET 357 HARTFORD TURNPIKE VERNON CT 06066-4800 860-871-9441

1366460339 WOO ALBERT 593 EDDY STREET PROVIDENCE RI 02903-4923 401-606-1248

1548374960 WOO DAVID 933 MAMARONECK AVENUE SUITE 202 MAMARONECK NY 10543-1661 917-513-8537

1033323258 WOODBURY ROBERT 1200 EAST PUTNAM AVENUE RIVERSIDE CT 06878-1430 203-637-8114

1285875062 WOODRUFF MARIANNE 455 TOLL GATE ROAD WARWICK RI 02886-2759 401-273-0641

1912900846 WOODS DANA 11 PHELP''S WAY WILLINGTON CT 06279-0349 860-429-5084

1154477388 WOODS SCOTT 34 PARK ST NEW HAVEN CT 06519-1109 203-974-7300

1437225695 WOODWARD JANET WILLOWS PEDIATRICS 1563 POST ROAD EAST WESTPORT CT 06880-5602 203-319-3939

1083875876 WORTMAN BETHANY 166 TOLLGATE ROAD WARWICK RI 02886-4411 401-273-0641

1205802212 WOYTOWICZ JOHN 149 N ST WATERVILLE ME 04901-4995 800-645-0355

1619956984 WOZNIAK JANET 55 FRUIT ST YAWKEY 6A BOSTON MA 02114-2621 617-726-2726

1730438318 WRIGHT CHRISTINA 263 FARMINGTON AVE FARMINGTON CT 06030-0001 860-679-5589

1447415039 WRIGTH DEBORRAH 1515 ALLEN STREET SUITE B SPRINGFIELD MA 01118-1803 413-782-7646

1457477853 WU JOHNNY 263 FARMINGTON AVE UCHC-CMHC FARMINGTON CT 06032-1956 860-679-5500

1386658219 WUDARSKY MARIANNE 915 RIVER ROAD MIDDLETOWN CT 06457-4402 820-704-4272

1134565237 WURMSER RACHEL 300 GEORGE STREET, SUITE 901 YNHH DEPT OF PSYCHIATRY NEW HAVEN CT 06511-6617 203-785-2089

1316083058 WURZEL CAROL CHILDREN'S & WOMAN'S PHYSICI 222 WESTCHESTER AVE. STE 202 WHITE PLAINS NY 10604-2926 914-922-2241

1780032797 WYBO KATHERINE 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1760771794 WYLIE JAMES 263 FARMINGTON AVENUE MC 4037 FARMINGTON CT 06030-4037 860-679-6600

1124199708 WYNN PE 800 CROSS RIVER ROAD KATONAH NY 10536-0800 914-763-8151

1275523359 XAVIER RAMNIK 55 FRUIT ST BLK 4 BOSTON MA 02114-2696 617-724-6007

1477586972 XENAKIS MARK 13710 ST FRANCIS BLVD MIDLOTHIAN VA 23114-3267 888-851-7590

1447209895 XIONG YUTING 970 SUMMER STREET, FLOOR 2 STAMFORD CT 06905-5518 203-324-2128

1992841167 XU WEI 100 WELLS STREET SUITE 1B HARTFORD CT 06103-2920 860-249-4466

1104915487 YAGHOUBIAN ROBERT 226 WHITE ST DANBURY CT 06810-6814 203-797-1500

1063511210 YALE ABRAHAM 1881 POST RD FAIRFIELD CT 06824-5721 203-255-1036

1194111617 YANCOPOULOS KAREN 31 RIVER RD COS COB CT 06807-2152 203-863-2003

1972654226 YARMOSKY LOUIS 100 MAPLE AVE SUITE 2 GREAT BARRINGTON MA 01230-1963 413-499-4850

1033260385 YARMOSKY STEVEN 100 MAPLE AVE SUITE 2 GREAT BARRINGTON MA 01230-1963 413-528-4490

1265775084 YARNELL STEPHANIE 300 COLLEGE STREET YUSM DEPT OF PSYCHIATRY NEW HAVEN CT 06511-0805 203-785-2094

1821044801 YATCHMINK YVETTE 593 EDDY STREE PROVIDENCE RI 02903-4923 401-444-5440

1043576747 YEH JUDY 20 YORK ST. YNHH TOMPKINS 226 NEW HAVEN CT 06510-3220 203-688-9503

1831577303 YERMAKOV OLEG 3300 MAIN STREET 3RD FLOOR, SUITE C&D SPRINGFIELD MA 01199-1619 413-794-7033

1447403522 YOO MONN-HEE CAPITOL REGION MENTAL HEALTH C 500 VINE STREET HARTFORD CT 06112-1639 860-297-0999

1619997004 YOON MINSUNG 1300 POST RD SUITE 101 FAIRFIELD CT 06824-6012 203-259-7870

1407964661 YORKE JENNIFER 601 E. ROLLINS STREET ORLANDO FL 32803-1248 800-645-3055

1205840659 YOUNES MARIA 2138 MENDON ROAD UNIT 104 CUMBERLAND RI 02864-3832 401-334-0424

1811954746 YOUNG AMY 2876 MAIN STREET STRATFORD CT 06614-4984 203-696-6125

1891936365 YOUNG PENNY 770 SAYBROOK RD MIDDLETOWN CT 06457-4739 860-347-2776

1538226626 YOUNG WENDY 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

HUSKY Health Connecticut Page 65 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)

Page 66: OPR Provider Listing (Ordering/Prescribing/Referring)

NPI Last Name First Name Service Address Line 1 Service Address Line 2 City State Zip Code Phone Number

1972532976 YOUSUF ASIM 1101 NOTT ST SCHENECTADY NY 12308-2425 801-256-1900

1871791665 YU HELENA 1275 YORK AVE MEMORIAL SOLID TUMOR GROUP NEW YORK NY 10065-6007 646-227-3742

1063590826 YU IRENE 26 BURLING LN 2ND FL NEW ROCHELLE NY 10801-5625 914-235-1888

1154525921 YU WILLIAM 800 CROSS RIVER ROAD KATONAH NY 10536-3549 914-763-8151

1831522184 YUN HO 2 MEDICAL CENTER DRIVE SUITE 503 SPRINGFIELD MA 01199-1619 413-794-4440

1275780256 YUN RAYMOND 670 STONELEIGH AVE CARMEL NY 10512-3997 800-633-2243

1710908306 YUN RICHARD 400 PROSPECT STREET NEW HAVEN CT 06511-2181 203-909-6370

1679798482 ZABBO CHRISTOPHER 455 TOLL GATE RD WARWICK RI 02886-2759 401-737-7000

1043203995 ZAIDMAN GERALD 95 GRASSLAND RD WESTCHESTER MEDICAL CENTER VALHALLA NY 10595-1552 914-493-1599

1477652311 ZAIN MONA 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2770 203-932-5711

1932499092 ZAKKO LIAM 874 HOWARD AVENUE YNH GERIATRIC SERVICES NEW HAVEN CT 06519-1106 203-688-8200

1558599464 ZALUSKI KATE 101 DUDLEY STREET PROVIDENCE RI 02905-2401 401-273-0641

1164555132 ZANGER BRETT 714 CHASE PARKWAY SUITE 2A WATERBURY CT 06708-3012 203-757-1455

1114039229 ZAPATKA SUSAN 950 CAMPBELL AVENUE WEST HAVEN CT 06516-2770 203-932-5711

1831299882 ZARKOWSKY FRANK 21 ADAMS RD RIDGEFIELD CT 06877-5929 203-438-2309

1396858288 ZATMAN MARINA 122 SOUTH POMPERAUG AVE UNIT 2 WOODBURY CT 06798-3708 203-314-1986

1972527646 ZEITLIN KEITH 850 N. MAIN STREET EXT. BUILDING 2, SUITE 3B WALLINGFORD CT 06492-2469 203-284-1119

1962455311 ZELMAN ARTHUR 101 ROCKLAND AVE MAMARONECK NY 10543-3307 914-698-3210

1437201159 ZEPF ROBERT 401 WEST THAMES STREET BUILDING 301 NORWICH CT 06360-7176 860-859-4674

1437149226 ZEROOGIAN JOHN 2150 MAIN STREET SPRINGFIELD MA 01104-3300 860-741-6572

1477589174 ZIANIO LELA 400 CAPITAL BLVD ROCKY HILL CT 19713-3101 860-652-5481

1912117714 ZIGUN JENNIFER VA CT HEALTHCARE SYSTEM 555 WILLARD AVE. NEWINGTON CT 06111-2631 860-667-6763

1730269317 ZILAHY PETER 35 CANDEE HILL RD WATERTOWN CT 06795-3101 860-274-9641

1538489315 ZIMMERMAN PATRICK 315 S MANNING BLVD ALBANY NY 12208-1707 800-645-3055

1003275892 ZINKUS DANIEL 55 LAKE AVENUE NORTH UMASS MEMORIAL MEDICAL GROUP WORCESTER MA 01655-0002 774-443-7552

1396839759 ZONANA HOWARD 34 PARK STREET NEW HAVEN CT 06519-1109 203-974-7016

1821528506 ZUCKER SUSAN 55 LAKE AVENUE NORTH WORCESTER MA 01655-0002 508-334-6173

1720457104 ZULLO ERIN 400 CAPITAL BLVD 3RD FLOOR ROCKY HILL CT 06067-3576 860-221-0791

1225059116 ZWAS FELICE 500 WEST PUTNAM AVE SUITE 100 GREENWICH CT 06830-6086 203-863-2908

1932292752 ZWEIG ELLIOT 41 NORTH MAIN STREET WEST HARTFORD CT 06107-1972 860-561-0580

HUSKY Health Connecticut Page 66 of 66 8/17/2017 6:15:10 AM

OPR Provider Listing (Ordering/Prescribing/Referring)