Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 023275 | CT |
NPI | 1003890542 |
---|---|
Provider Name | Dennis Morgan |
First Address | Enfield, CT 06082-4571 |
Second Address | Enfield, CT 06082-4571 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 02/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001232750 | (05) | CT |
C65107 | (02) |