Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 021441 | CT |
Y | 208600000X | Surgeon | 021441 | CT |
NPI | 1023054293 |
---|---|
Provider Name | John B. Famiglietti |
First Address | Brookfield, CT 06804-1306 |
Second Address | Danbury, CT 06810-6129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001214410 | (05) | CT |
B38354 | (02) | CT |
OV3791 | GENERAL SURGERY (01) | CT |