Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD435965 | PA |
NPI | 1013192061 |
---|---|
Provider Name | Dr. Pramod Bonde |
First Address | New Haven, CT 06510-3218 |
Second Address | New Haven, CT 06510-3218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2008 |
Last Update Date | 02/10/2012 |