Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 25632 | CT |
N | 207XS0117X | Orthopaedic Spine Surgeon | 25632 | CT |
NPI | 1306865407 |
---|---|
Provider Name | Jonas Lieponis |
First Address | Hamden, CT 06518-3209 |
Second Address | Milford, CT 06460-3226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 24/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B38017 | (02) | CT |