Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 247595 | MA |
N | 111NI0900X | Internist | 247595 | MA |
N | 207RC0000X | Internist - Cardiovascular Disease | 256118 | MA |
N | 207RC0000X | Internist - Cardiovascular Disease | 62383 | CT |
N | 207RI0011X | Interventional Cardiology | 16163 | RI |
Y | 207RI0011X | Interventional Cardiology | 62383 | CT |
NPI | 1003100223 |
---|---|
Provider Name | Dr. Edward Thomas Carreras |
First Address | Stratford, CT 06614-4819 |
Second Address | Stratford, CT 06614-4819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2011 |
Last Update Date | 03/07/2019 |