Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 62499 | CT |
NPI | 1003177965 |
---|---|
Provider Name | Dr. David Jay Altszuler |
First Address | Wallingford, CT 06492-2576 |
Second Address | Hartford, CT 06106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2012 |
Last Update Date | 16/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008087874 | (05) | CT |