Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 041434 | CT |
NPI | 1013953777 |
---|---|
Provider Name | Jaime Strachan |
First Address | Shelton, CT 06484-6228 |
Second Address | Watertown, CT 06795-3356 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 23/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013953777 | (05) | CT |
I34690 | (02) | CT |