Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 000445 | CT |
NPI | 1104877653 |
---|---|
Provider Name | Dr. Richard Paul Saporito |
First Address | Bristol, CT 06011-0262 |
Second Address | Bristol, CT 06010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050000445CT01 | (02) | CT |
050445 | (02) | CT |
44-04593 | (02) | CT |
948473 | (02) | CT |
P792545 | (02) | CT |
T23412 | (02) |