Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 033702 | CT |
NPI | 1043409667 |
---|---|
Provider Name | Dr. Leila J. Garrett |
First Address | Greenwich, CT 06830-4607 |
Second Address | Greenwich, CT 06830-4607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2007 |
Last Update Date | 09/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010033702CT02 | ANTHEM BLUE CROSS (01) | CT |
F85512 | (02) | CT |