Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 035101 | CT |
NPI | 1003809385 |
---|---|
Provider Name | Richard Paul Santarosa |
First Address | Stamford, CT 06902-3661 |
Second Address | Stamford, CT 06902-3661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 09/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G43015 | (02) |