Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD465877 | PA |
Y | 2080P0216X | Pediatric Rheumatologist | 68777 | CT |
NPI | 1487032488 |
---|---|
Provider Name | Daniel Glaser |
First Address | New Haven, CT 06520-8064 |
Second Address | New Haven, CT 06510-3206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2015 |
Last Update Date | 02/07/2021 |