Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 021412 | CT |
NPI | 1134102361 |
---|---|
Provider Name | Joseph E Craft |
First Address | New Haven, CT 06536-0805 |
Second Address | New Haven, CT 06519-1304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 26/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001214121 | (05) | CT |
D85269 | (02) |