Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 64931 | CT |
Y | 2086S0105X | Surgery of the Hand | 64931 | CT |
NPI | 1063831550 |
---|---|
Provider Name | Jill Putnam |
First Address | Glastonbury, CT 06033-4353 |
Second Address | Glastonbury, CT 06033-4353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2014 |
Last Update Date | 07/01/2022 |