Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 167 | CT |
N | 111NN1001X | Nutrition | 000167 | CT |
NPI | 1629132766 |
---|---|
Provider Name | Dr. Joseph James Neal |
First Address | Glastonbury, CT 06033 |
Second Address | Glastonbury, CT 06033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 20/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050000167CT01 | BLUE CROSS BLUE SHIELD (01) | |
0511238 | AETNA (01) | |
1023268810 | (02) | CT |
350000111 | (02) | CT |
732518 | CONNECTICARE (01) | |
P485802 | OXFORD (01) |