Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 000575 | CT |
NPI | 1992806475 |
---|---|
Provider Name | Dr. Roger Mark Pappas |
First Address | West Haven, CT 06516-7307 |
Second Address | West Haven, CT 06516-7307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 02/08/2007 |