Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 033820 | CT |
NPI | 1023174745 |
---|---|
Provider Name | Mrs. Jean Guiness Henry |
First Address | Branford, CT 06405-2988 |
Second Address | Branford, CT 06405-2988 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 28/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F88175 | (02) | CT |