Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 039303 | CT |
N | 207PP0204X | Pediatric Emergency Physician | 039303 | CT |
N | 208000000X | Pediatrician | 039303 | CT |
NPI | 1245377175 |
---|---|
Provider Name | Dr. Morton Salomon |
First Address | Stamford, CT 06903-3327 |
Second Address | Bridgeport, CT 06606-4201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 09/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B79540 | (02) |