Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 041465 | CT |
NPI | 1528065851 |
---|---|
Provider Name | Dr. Biren V Chokshi |
First Address | Putnam, CT 06260-1939 |
Second Address | Putnam, CT 06260-1939 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2005 |
Last Update Date | 19/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001414656 | (05) | CT |
H98793 | (02) |