Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 031041 | CT |
NPI | 1053344424 |
---|---|
Provider Name | Dr. Antoine M Ferneini |
First Address | North Haven, CT 06473-2132 |
Second Address | North Haven, CT 06473-2132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 09/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001310416 | (05) | CT |
F69899 | (02) | CT |