Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 02280 | CT |
Y | 207W00000X | Ophthalmologist | 022880 | CT |
NPI | 1023054756 |
---|---|
Provider Name | Dr. Susan Hall Forster |
First Address | New Haven, CT 06520-8237 |
Second Address | New Haven, CT 06520-8237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 20/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C59721 | (02) | CT |