Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 061068 | CT |
NPI | 1346656774 |
---|---|
Provider Name | Dr. Jaclyn Beirne |
First Address | Farmington, CT 06030-8082 |
Second Address | Farmington, CT 06032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2014 |
Last Update Date | 08/05/2019 |