Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 41415 | WI |
NPI | 1891764841 |
---|---|
Provider Name | Christopher T Healy |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53715-1375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 20/01/2021 |