Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 025272 | CT |
NPI | 1174630651 |
---|---|
Provider Name | Dr. Karol Joseph Chacho |
First Address | Bridgeport, CT 06606 |
Second Address | Bridgeport, CT 06606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000362 | HEALTHNET (01) | CT |
010025272CT01 | ANTHEM BCBS (01) | CT |
709157 | CONNECTICARE (01) | CT |