Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 040418 | CT |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 040418 | CT |
NPI | 1093816969 |
---|---|
Provider Name | Dennis M. Rodin |
First Address | Waterbury, CT 06708-3106 |
Second Address | Waterbury, CT 06708-3106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 25/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001404186 | (05) | CT |
010040418CT01 | ANTHEM BCBS (01) | CT |
040418 | CONNECTICARE (01) | CT |
2522042 | UNITED HC (01) | CT |
2V2068 | HEALTHNET (01) | CT |
H56532 | (02) | CT |
P2679357 | OXFORD (01) | CT |