Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 217664 | NY |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 217664 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 47186 | CT |
NPI | 1053375915 |
---|---|
Provider Name | Andrew Paul Mackenzie |
First Address | Putnam, CT 06260-1871 |
Second Address | Putnam, CT 06260-1871 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 26/09/2016 |