Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 019689 | CT |
NPI | 1376519579 |
---|---|
Provider Name | Henry Feder |
First Address | Hartford, CT 06106-3322 |
Second Address | Hartford, CT 06106-3322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001196898 | (05) | CT |
D02912 | (02) | CT |