Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 006173 | CT |
NPI | 1669518932 |
---|---|
Provider Name | Dr. Kevin Sean Mclaughlin |
First Address | Norwalk, CT 06851-5721 |
Second Address | Norwalk, CT 06851-5721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 27/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T22021 | (02) | CT |