Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 029824 | CT |
NPI | 1639193741 |
---|---|
Provider Name | Gregory Dworkin |
First Address | Danbury, CT 06810-6099 |
Second Address | Danbury, CT 06810-6099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F10519 | (02) | CT |