Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 125.058847 | IL |
N | 208600000X | Surgeon | 125.058847 | IL |
Y | 2086S0105X | Surgery of the Hand | 053982 | CT |
NPI | 1245521442 |
---|---|
Provider Name | Steven Vander Naalt |
First Address | Glastonbury, CT 06033-1208 |
Second Address | Glastonbury, CT 06033-1208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2011 |
Last Update Date | 15/07/2015 |