Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 56574 | CT |
NPI | 1174720957 |
---|---|
Provider Name | Dr. Stephan Siebel |
First Address | New Haven, CT 06510-3218 |
Second Address | New Haven, CT 06510-3218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 17/03/2018 |