Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 67396 | CT |
NPI | 1821416793 |
---|---|
Provider Name | Dr. Abdelghaffar Salous |
First Address | Glastonbury, CT 06033-4353 |
Second Address | Glastonbury, CT 06033-4353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2014 |
Last Update Date | 03/06/2021 |