Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 021993 | CT |
NPI | 1033171608 |
---|---|
Provider Name | Dr. Jeffrey L Oberman |
First Address | Fairfield, CT 06824-5670 |
Second Address | Fairfield, CT 06824-5670 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 03/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001219930 | (05) | CT |
D80766 | (02) | CT |