Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 033471 | CT |
N | 207KA0200X | Allergist | 177320 | NY |
N | 207KA0200X | Allergist | 25MA07491400 | NJ |
N | 208000000X | Pediatrician | 033471 | CT |
NPI | 1578530507 |
---|---|
Provider Name | Pamela Laurie Kwittken |
First Address | Milford, CT 06460-3535 |
Second Address | Milford, CT 06460-3535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 25/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001334713 | (05) | CT |
F20993 | (02) | CT |