Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 8693 | CT |
NPI | 1104462555 |
---|---|
Provider Name | Emily Garth |
First Address | West Hartford, CT 06119-1021 |
Second Address | Hartford, CT 06105-1208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2019 |
Last Update Date | 12/11/2021 |