Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 4715 | CT |
N | 213EG0000X | General Practice | 4715 | CT |
N | 124Q00000X | Dental Hygienist |
NPI | 1053481267 |
---|---|
Provider Name | Dr. Jeffrey D Altman |
First Address | East Hartford, CT 06108-2238 |
Second Address | East Hartford, CT 06108-2238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |