Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 6825 | CT |
NPI | 1750301982 |
---|---|
Provider Name | Dr. Paul A Bocciarelli |
First Address | Rocky Hill, CT 06067-1851 |
Second Address | Rocky Hill, CT 06067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |