Active NPI
Ronald Demakovsky, PHD
- Psychologist
- Middletown, CT
National Provider Identifier
1992865695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 001243
- Practice address
- 351 Silver Street
River Valley Services Dutton Home
Middletown, CT 06457 - Phone
- (860) 262-5358
- Fax
- (860) 262-5356
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 001243 | CT | Primary |
Addresses
Primary practice location
351 Silver Street
River Valley Services Dutton Home
Middletown, CT 06457
Mailing address
PO Box 351 Silver Street
River Valley Services Dutton Home
Middletown, CT 06457
Phone (860) 262-5358
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001243 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992865695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 351 SILVER STREET",
"address_2": "RIVER VALLEY SERVICES DUTTON HOME",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "06457",
"telephone_number": "860-262-5358",
"fax_number": "860-262-5356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "351 SILVER STREET",
"address_2": "RIVER VALLEY SERVICES DUTTON HOME",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "06457",
"telephone_number": "860-262-5358",
"fax_number": "860-262-5356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMAKOVSKY",
"first_name": "RONALD",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "001243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.