Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 033247 | CT |
NPI | 1033192257 |
---|---|
Provider Name | Louise Marie Dembry |
First Address | New Haven, CT 06536-0805 |
Second Address | New Haven, CT 06519-1304 |
Gender | F |
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 |
---|---|---|
001332478 | (05) | CT |
F63516 | (02) |