Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 022484 | CT |
NPI | 1053320903 |
---|---|
Provider Name | Dr. Charles J. Ingardia |
First Address | Hartford, CT 06151-0634 |
Second Address | Hartford, CT 06102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 25/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E42828 | (02) | CT |