Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 029085 | CT |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 029085 | CT |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 029085 | CT |
NPI | 1831200187 |
---|---|
Provider Name | George Bittmann Barth II |
First Address | New Milford, CT 06776-3427 |
Second Address | Waterbury, CT 06706-1748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 22/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1290858 | (05) | CT |
C-82721 | (02) |