Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 55147 | CT |
NPI | 1013353028 |
---|---|
Provider Name | Jacob Bartel Lotstein |
First Address | Bethel, CT 06801-1040 |
Second Address | Danbury, CT 06810-6099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2013 |
Last Update Date | 11/07/2016 |