Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 867 | CT |
N | 111NS0005X | Chiropractic Sports Physician | 867 | CT |
NPI | 1821025156 |
---|---|
Provider Name | Dr. Daniel Warren Kerzner |
First Address | Waterford, CT 06385-4039 |
Second Address | Waterford, CT 06385-4039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 23/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004111837 | (05) | CT |
008045569 | (05) | CT |
1821025156 | NPI (01) | CT |
U02459 | (02) | CT |