Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 013883 | CT |
NPI | 1649266651 |
---|---|
Provider Name | Dr. James D. Slavin JR. |
First Address | Hartford, CT 06105-1770 |
Second Address | Hartford, CT 06105-1208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 13/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B38302 | (02) |