Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 56291 | CT |
NPI | 1043479090 |
---|---|
Provider Name | Daniel Ethan Boxer |
First Address | Norwalk, CT 06850-3852 |
Second Address | Norwalk, CT 06850-3852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00773616 | RAILROAD MEDICARE (01) | DC |