Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 172277 | CT |
N | 207XS0117X | Orthopaedic Spine Surgeon | 172277 | CT |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 172277 | CT |
NPI | 1386695096 |
---|---|
Provider Name | Dr. Kenneth J Paonessa |
First Address | North Franklin, CT 06254-1807 |
Second Address | North Franklin, CT 06254-1807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E34473 | (02) | CT |