Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 043343 | CT |
N | 207R00000X | Internist | 043343 | CT |
N | 111NI0900X | Internist | 043343 | CT |
NPI | 1073596714 |
---|---|
Provider Name | Sharon Stacy Farber |
First Address | West Hartford, CT 06117-3949 |
Second Address | West Hartford, CT 06117-3949 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 03/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I31316 | (02) |