Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 037882 | CT |
N | 207V00000X | Obstetrician & Gynecologist | 037882 | CT |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 037882 | CT |
NPI | 1063471092 |
---|---|
Provider Name | Gary E Kleinman |
First Address | Bridgeport, CT 06610-0246 |
Second Address | Bridgeport, CT 06610-2811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A98285 | (02) | CT |