Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 000799 | CT |
Y | 222Z00000X | Podiatrist | 000799 | CT |
N | 213EP1101X | Primary Podiatric Medicine | 000799 | CT |
NPI | 1578577870 |
---|---|
Provider Name | Dr. Jennifer Elizabeth Tauber |
First Address | New Canaan, CT 06840-6015 |
Second Address | Bethel, CT 06801-1846 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 06/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V03884 | (02) | CT |