Carl K Gjertson
Urologist Pediatric Urologist
263 Farmington Ave Urology
Farmington
, Connecticut 06030-6227
Carl K Gjertson
Urologist Pediatric Urologist
263 Farmington Ave Urology
Farmington
, Connecticut 06030-6227
(860) 679-1610
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About
Features
Specialties
- Urologist
- Pediatric Urologist
Languages spoken
- English
Location
First Address
- Carl K Gjertson
- 263 Farmington Ave Provider Enrollment
- Farmington, CT
- Zip : 06030-2212
- Fax : (860) 679-1610
- Phone : (860) 679-7503
Second Address
- Carl K Gjertson
- 263 Farmington Ave Urology
- Farmington, CT
- Zip : 06030-6227
- Fax : (860) 679-1390
- Phone : (860) 679-4100
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Is Carl K Gjertson a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208800000X | Urologist | 045171 | CT |
| N | 2088P0231X | Pediatric Urologist | 045171 | CT |
National Provider Identifier
| NPI | 1063472017 |
|---|---|
| Provider Name | Carl K Gjertson |
| First Address | Farmington, CT 06030-2212 |
| Second Address | Farmington, CT 06030-6227 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/03/2006 |
| Last Update Date | 10/04/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1063472017 | (05) | CT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.