Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 048852 | CT |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 048852 | CT |
NPI | 1396940722 |
---|---|
Provider Name | Katherine Nau Grieco |
First Address | Hartford, CT 06106-3309 |
Second Address | Hartford, CT 06106-3309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2007 |
Last Update Date | 25/09/2020 |