Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 050789 | CT |
N | 207RP1001X | Pulmonary Disease | 050789 | CT |
NPI | 1043493869 |
---|---|
Provider Name | Felipe Lopez Gonzalez |
First Address | Cheshire, CT 06410 |
Second Address | New Haven, CT 06511-4405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2007 |
Last Update Date | 19/09/2014 |