Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 023467 | CT |
NPI | 1073690517 |
---|---|
Provider Name | Marian Nicole Sarosi |
First Address | New London, CT 06320-4521 |
Second Address | New London, CT 06320-4521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |