Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 67619 | CT |
NPI | 1669869053 |
---|---|
Provider Name | Dr. Gunjan Garg |
First Address | Bridgeport, CT 06610 |
Second Address | Bridgeport, CT 06610-2805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2015 |
Last Update Date | 07/06/2021 |