Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | PENDING | CT |
NPI | 1518900133 |
---|---|
Provider Name | Amy K. Brown |
First Address | Hartford, CT 06151-0634 |
Second Address | Hartford, CT 06102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 25/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I54509 | (02) | CT |