Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 023341 | CT |
NPI | 1053335299 |
---|---|
Provider Name | Roy E. Kalman |
First Address | Ansonia, CT 06401-0659 |
Second Address | Ansonia, CT 06401-1158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B83698 | (02) | CT |