Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 035629 | CT |
NPI | 1063423028 |
---|---|
Provider Name | Hossein Sadeghi |
First Address | Stamford, CT 06902-2594 |
Second Address | Stamford, CT 06902-2594 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 29/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H09513 | (02) | CT |