Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 017525 | CT |
NPI | 1346207990 |
---|---|
Provider Name | Dr. Ira Lawrence Spar |
First Address | Plantsville, CT 06479-1538 |
Second Address | Plantsville, CT 06479-1538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 11/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1175256 | (05) | CT |
B83364 | (02) | CT |