Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 033609 | CT |
NPI | 1295819985 |
---|---|
Provider Name | Dr. Haik G Kavookjian |
First Address | Stamford, CT 06905-3330 |
Second Address | Stamford, CT 06905-3330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A59215 | (02) |