Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 034917 | CT |
Y | 111NI0900X | Internist | 034917 | CT |
N | 207RA0401X | Internist - Addiction Medicine | 034917 | CT |
NPI | 1316934185 |
---|---|
Provider Name | Karen S Guadagnini |
First Address | Bristol, CT 06011-2828 |
Second Address | Bristol, CT 06010-4190 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 22/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001349176 | (05) | CT |
F44446 | (02) |