Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 36265 | CT |
NPI | 1013458447 |
---|---|
Provider Name | James Magner |
First Address | Woodbridge, CT 06525-2638 |
Second Address | Woodbridge, CT 06525-2638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2017 |
Last Update Date | 18/03/2017 |