Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 10357 | CT |
Y | 213EG0000X | General Practice | 10357 | CT |
NPI | 1003044157 |
---|---|
Provider Name | John Dannon |
First Address | Canaan, CT 06018-2481 |
Second Address | Canaan, CT 06018-2481 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2009 |
Last Update Date | 23/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008032193 | (05) | CT |