Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 043777 | CT |
Y | 208600000X | Surgeon | 043777 | CT |
NPI | 1003995804 |
---|---|
Provider Name | Gerard Andrew Betro |
First Address | New Haven, CT 06536-0805 |
Second Address | New Haven, CT 06519-1369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 08/07/2007 |