Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 008773 | CT |
NPI | 1104902931 |
---|---|
Provider Name | Gita Safaian |
First Address | Lyme, CT 06371 |
Second Address | Hamden, CT 06518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 08/07/2007 |