Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 001078 | CT |
NPI | 1144263922 |
---|---|
Provider Name | Diane M Paquette |
First Address | New Haven, CT 06520-8237 |
Second Address | New Haven, CT 06520-8237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 26/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P15269 | (02) | CT |