Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 028123 | CT |
NPI | 1063438406 |
---|---|
Provider Name | Dr. Howard Quentzel |
First Address | Derby, CT 06418-1326 |
Second Address | Derby, CT 06418-1326 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 04/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B84042 | (02) | CT |