Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 038745 | CT |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 038745 | CT |
NPI | 1235197328 |
---|---|
Provider Name | Lane D Spero |
First Address | Torrington, CT 06790-3493 |
Second Address | Torrington, CT 06790-3493 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 17/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001387457 | (05) | CT |
010038745CT01 | BC (01) | CT |
7715005 | AETNA (01) | CT |
F99698 | (02) |