Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 02231 | CT |
NPI | 1023015542 |
---|---|
Provider Name | Dr. Jeffrey N Alter |
First Address | Waterbury, CT 06708-2651 |
Second Address | Waterbury, CT 06708-2651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2005 |
Last Update Date | 02/07/2014 |