Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 11042 | CT |
N | 1223P0700X | Prosthodontist | P70931 | NY |
NPI | 1073741104 |
---|---|
Provider Name | Dr. Ramzi Hindieh |
First Address | Manchester, CT 06040-3863 |
Second Address | Manchester, CT 06040-3863 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2009 |
Last Update Date | 22/08/2013 |