Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 019375 | CT |
Y | 111NI0900X | Internist | 019375 | CT |
N | 207RR0500X | Rheumatology | 019375 | CT |
NPI | 1023032208 |
---|---|
Provider Name | Dr. Alan Michael Spagnola |
First Address | Essex, CT 06426-1154 |
Second Address | Essex, CT 06426-1154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 30/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001193754 | (05) | CT |
B83995 | (02) | CT |