Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 039385 | CT |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 039385 | CT |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 039385 | CT |
NPI | 1215936992 |
---|---|
Provider Name | Paul Protomastro |
First Address | Norwalk, CT 06851-1080 |
Second Address | Norwalk, CT 06851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2005 |
Last Update Date | 28/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H17244 | (02) | CT |