Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 016924 | CT |
N | 2080P0216X | Pediatric Rheumatologist | 016924 | CT |
NPI | 1962485185 |
---|---|
Provider Name | Paul L Mccarthy |
First Address | New Haven, CT 06510-3221 |
Second Address | New Haven, CT 06510-3221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 15/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001169242 | (05) | CT |
E48021 | (02) |