Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 51925 | CT |
N | 207NP0225X | Pediatric Dermatologist | 51925 | CT |
NPI | 1053554667 |
---|---|
Provider Name | Brittany Craiglow |
First Address | Fairfield, CT 06824-5849 |
Second Address | Fairfield, CT 06824-5849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2009 |
Last Update Date | 17/04/2018 |