Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MT186325 | PA |
Y | 207YP0228X | Pediatric Otolaryngology | CT049445 | CT |
NPI | 1922216001 |
---|---|
Provider Name | Dr. Christopher Robert Grindle |
First Address | South Glastonbury, CT 06073-3543 |
Second Address | Hartford, CT 06106-3322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2007 |
Last Update Date | 16/11/2011 |