Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 040272 | CT |
NPI | 1982613659 |
---|---|
Provider Name | Brian J Hines |
First Address | Stamford, CT 06902-1627 |
Second Address | Stamford, CT 06902-1627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 07/09/2018 |