Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 66486 | CT |
N | 208600000X | Surgeon | 66486 | CT |
Y | 2086S0120X | Pediatric Surgery | 66486 | CT |
NPI | 1245522077 |
---|---|
Provider Name | Matthew Alan Hornick |
First Address | Guilford, CT 06437-2220 |
Second Address | New Haven, CT 06510-3218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2011 |
Last Update Date | 14/09/2020 |