Basic Information
| Provider Information | |||||||||
| NPI: | 1346240769 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FERRARO-BORGIDA | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 RETREAT AVE | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061062528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605225712 | ||||||||
| FaxNumber: | 8605204270 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 RETREAT AVE | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061062528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605225712 | ||||||||
| FaxNumber: | 8605204270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2005 | ||||||||
| LastUpdateDate: | 05/26/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 035180 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 010035180CT01 | 01 | CT | ANTHEM BC/BS ID# | OTHER | P12038323 | 01 | CT | MULTIPLAN ID# | OTHER | P2003061 | 01 | CT | OXFORD ID# | OTHER | 001351808 | 05 | CT | MEDICAID | 0351800446 | 01 | CT | CONNECTICARE ID# | OTHER | 24569 | 01 | CT | HEALTH NEW ENGLAND ID# | OTHER | 2133813002 | 01 | CT | CIGNA HEALTHPLAN ID# | OTHER | 2135563 | 01 | CT | AETNA HEALTH ID# | OTHER | OV5249 | 01 | CT | HEALTHNET ID# | OTHER |