Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 009509 | CT |
N | 213EG0000X | General Practice | 009509 | CT |
Y | 1223P0106X | Oral and Maxillofacial Pathology | 009509 | CT |
NPI | 1548473523 |
---|---|
Provider Name | Dr. Easwar Natarajan |
First Address | Farmington, CT 06030-2820 |
Second Address | Farmington, CT 06030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 13/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1548473523 | (05) | CT |