Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 32215 | CT |
NPI | 1003985805 |
---|---|
Provider Name | Dr. Claudio A. Benadiva |
First Address | Farmington, CT 06032-2568 |
Second Address | Farmington, CT 06032-2568 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 01/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F66502 | (02) |