Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 6838 | CT |
NPI | 1053322917 |
---|---|
Provider Name | Dr. Robert Gerard Zborowski |
First Address | Ellington, CT 06029-2126 |
Second Address | Vernon, CT 06066-4784 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T22624 | (02) | CT |