Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 034211 | CT |
NPI | 1023125523 |
---|---|
Provider Name | Dr. Louis A. Telesford |
First Address | Hamden, CT 06518-3539 |
Second Address | Hamden, CT 06518-3539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 06/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
034211 | MEDICAL LICENSE (01) | CT |
F36860 | (02) | CT |