Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 61439 | CT |
NPI | 1003182023 |
---|---|
Provider Name | Matthew Joseph Mcconnell |
First Address | New Haven, CT 06510-3206 |
Second Address | New Haven, CT 06510-3206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2012 |
Last Update Date | 17/08/2018 |