Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 033824 | CT |
NPI | 1013013671 |
---|---|
Provider Name | Dr. Peter Eugene Libre |
First Address | Norwalk, CT 06851-5014 |
Second Address | Norwalk, CT 06851-5014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 16/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001338244 | (05) | CT |
01554461 | (05) | NY |
F79003 | (02) |