Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 515CT01 | CT |
NPI | 1235151127 |
---|---|
Provider Name | Ms. Gina Marie Gubitosi |
First Address | Cheshire, CT 06410-3200 |
Second Address | Cheshire, CT 06410-3200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2006 |
Last Update Date | 08/07/2007 |