Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 000250 | CT |
NPI | 1437153012 |
---|---|
Provider Name | Dr. Allan R Mayer |
First Address | Hartford, CT 06105-1719 |
Second Address | Hartford, CT 06105-1719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 19/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010025000 | (05) | CT |
E40964 | (02) | CT |