Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 17706 | CT |
NPI | 1013956010 |
---|---|
Provider Name | Jeffrey D Gold |
First Address | Hamden, CT 06518-3222 |
Second Address | Hamden, CT 06518-3222 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 09/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B37683 | (02) |