Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 035214 | CT |
NPI | 1033176896 |
---|---|
Provider Name | Peter J. Mcallister |
First Address | Fairfield, CT 06824-5340 |
Second Address | Fairfield, CT 06824-5340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 01/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001352145 | (05) | CT |
010035214CT01 | ANTHEM BLUE CROSS AND BLU (01) | CT |
G24329 | (02) | CT |