Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 021601 | CT |
NPI | 1356478408 |
---|---|
Provider Name | David Jacob Nochimson |
First Address | North Granby, CT 06060-1404 |
Second Address | North Granby, CT 06060-1404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1216019 | (05) | NJ |
B84255 | (02) | NJ |