Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 069261 | CT |
N | 207T00000X | Neurosurgeon | A169594 | CA |
NPI | 1003158486 |
---|---|
Provider Name | Mr. Ian Thomas Mcneill |
First Address | Farmington, CT 06030-8063 |
Second Address | Farmington, CT 06030-8063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2013 |
Last Update Date | 13/08/2021 |