Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 033435 | CT |
Y | 207RC0000X | Internist - Cardiovascular Disease | 033435 | CT |
NPI | 1255334207 |
---|---|
Provider Name | Richard Soucier |
First Address | Hartford, CT 06105-1770 |
Second Address | Hartford, CT 06105-1208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 11/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001334359 | (05) | CT |
G37130 | (02) | CT |