Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 022203 | CT |
Y | 208600000X | Surgeon | 022203 | CT |
N | 2086S0129X | Vascular Surgeon | 022203 | CT |
N | 2086X0206X | Surgical Oncologist | 022203 | CT |
N | 208C00000X | Colorectal Surgeon | 022203 | CT |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 022203 | CT |
NPI | 1275512576 |
---|---|
Provider Name | Dr. Paul K. Safer |
First Address | Portland, CT 06480-1781 |
Second Address | Middletown, CT 06457-4700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2006 |
Last Update Date | 28/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001222033 | (05) | CT |
B38008 | (02) | CT |