Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 640 | CT |
NPI | 1144233834 |
---|---|
Provider Name | Dr. Richard A Sennett |
First Address | Avon, CT 06001-2315 |
Second Address | Windsor, CT 06095-1795 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4135796 | (05) | CT |
U03151 | (02) | CT |