Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 039208 | CT |
NPI | 1184698565 |
---|---|
Provider Name | Dr. Sonnel J Patrick |
First Address | Waterbury, CT 06708-3339 |
Second Address | Waterbury, CT 06708-3339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 17/09/2013 |